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SPINAL 
TREATMENT 



Spinal treatment; auxiliary methods of 
treatment designed for the use of those who 
believe in and appreciate the true principle 
of progress in the healing art, namely, try 
all things with an open mind, and hold fast to 
that which is found to be good, 



by 

Alva A. Gregory, M.D. 
£d ed. rev, and enl. 



Oklahoma City, Oklahoma. 
The Palmer-Gregory College 

[cl912] 
(Us 



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THIS VOLUME IS DEDICATED 

WITH PROFESSIONAL COURTESY 

TO 

PROFESSORS OF THE HEALING ART 

MY COLABORERS IN COMBATING THE INROADS OF 

DISEASE AND IN RELIEVING HUMANITY 

OF PAIN AND SUFFERING 

BY 

THE AUTHOR 



PREFACE TO FIRST EDITION. 

THE main object in view in the preparation of this 
volume has been to explain a special method of 
treatment and to place that method upon a 
scientific basis, since we feel that it will prove an impor- 
tant auxiliary to the present methods of the practitioners 
of the healing art, who have by an expenditure of time 
and money prepared themselves for their lifework of 
combating disease. 

I am aware that many may differ with me in many 
of the statements made, before they have fully tested 
their correctness; also, that unintentional and unavoid- 
able errors have crept into the text. 

This work, especially the first section, is entirely 
along new lines of thought. Having no precedent, con- 
siderable repetition has crept in, and we find it very 
difficult to eradicate the same without the expenditure 
of much time; besides, the repetition will serve to impress 
many of the important fundamental principles; and we 
feel sure that this volume will be of great interest to 
any one of an investigating turn of mind. 

We are too close upon the heels of such remarkable 
discoveries as the phonograph, the telephone, the aero- 
plane, and wireless telegraphy, to prejudge and criticise 
any new invention or discovery. 

Before Edison's marvelous discovery and invention 
of the phonograph, who would have believed the possi- 
bility of reproducing the human voice from a machine? 
It is truly a marvel, but it is now an accepted fact. 

Who, then, is sufficiently wise to say what the next 
great discovery is or will be? It may be in the healing 
art, and those who have investigated spinal adjustment 
declare that it is. 



viii Preface to First Edition. 

The author, during the past three years, has given 
himself almost wholly to an investigation of the merits of 
this science, that before, to him, were entirely unknown. 
In our research we have made it our primary object to 
test the merits of spinal adjustment as to its efficacy 
and potency as a means of relieving disease, both acute 
and chronic. 

The confidence the author has gained in this method 
is based upon special relief and removal of some ailments 
in his own case and the results that he has obtained in 
testing it upon hundreds of others afflicted with many 
different ailments. Many of the results obtained have 
been indeed remarkable — in fact, almost incredible — and 
very far exceeded his most sanguine expectations. 

It is the earnest desire of the author of this work to 
add an humble mite to the store of knowledge of the 
medical world, and to urge all physicians, whatever their 
school or training, to inspect this volume with the same 
spirit with which it has been prepared. 

Many are losing confidence in the regular practice of 
medicine of to-day; many discrediting statements are 
made concerning the use of drugs. The following is 
quoted from Dr. Oliver Wendell Holmes, forty years 
professor of anatomy in the Harvard University Medical 
School: "Mankind has been drugged to death, and the 
world would be better off, if the contents of every apothe- 
cary shop were emptied into the sea, though the conse- 
quences to the fish would be lamentable." 

Dr. A. C. Bernays, M. D., of Marion-Sims College, 
St. Louis, Missouri, says: "To give drugs to a well man 
is very wrong, but to give drugs to a sick man is nothing 
short of a crime." 

Dr. Evans, M. D., of Royal College, London, says: 
"The medical practice of to-day has neither philosophy 
nor common sense to commend it to our confidence." 

Dr. J. B. S. Allyne, M. M., Barnes Medical College, 



Preface to First Edition. ix 

St. Louis, Missouri, says: "Of all branches of learning, 
medicine is the most uncertain. Physic is the art of 
amusing the patient while nature cures the disease." 

The above quotations from men of our own ranks and 
of high standing therein are at least indicative of one 
important fact, and that is, that we have not yet reached 
a scientific and sufficiently successful system of treatment 
to command the respect of even our own profession, to 
say nothing of the failure of maintaining the full confi- 
dence of the laity. 

It is no wonder that so many people are losing confi- 
dence in our professional efficiency, and no wonder so 
many charlatans live and prosper. 

I am fully persuaded that we, as a professional medical 
body, owe it to our self-protection and the maintenance 
of our standing in the confidence of the laity, to live up 
to the true principle of progress in the healing art, viz., 
to "investigate every method of treatment that may 
accomplish good, with an open mind, and to hold fast to 
that which is found to possess true merit." This is the 
only method by which we will hold the confidence of the 
people. The best educated class of people to-day who 
offer to practice the healing art should possess every 
meritorious method, adjunct, or auxiliary that may be 
expediently and effectively employed. 

We believe that any treatment that has merit, as a 
palliative or as a curative agency, should be known to 
the medical profession, who are educated and qualified, 
first, to understand its merits; second, to make a proper 
use of it; and third and lastly, to develop any adjunct 
of merit so as to increase the amount of its potency and 
also the usefulness thereof. 

In the study and practice of this new system of 
treatment, we have found a solution for many things 
that were, to the author, unknown before. 

Many questions are, to our mind, now fully explained 



x Preface to First Edition. 

that before were mysteries, and for this reason we believe 
that a full explanation should be given to and enjoyed 
by the medical profession. 

Hydrotherapy, the water cure, was first introduced 
and used by an uneducated class outside of the medical 
profession. Since the medical profession have adopted 
this treatment as an auxiliary method they have greatly 
improved the former procedures of hydrotherapy and 
made it a much more potent auxiliary. 

One of the author's former teachers, Dr. J. H. Kellogg, 
of Battle Creek, Michigan, was dissatisfied when he 
graduated as a water-cure doctor, feeling that he knew 
entirely too little to offer his services as such. He applied 
himself diligently to the study of medicine, and after 
this educational preparation he has accomplished more 
than any other living physician in the development of 
hydrotherapy and its practical modes of application. 

Electricity was used as a remedial agent by men out- 
side of the medical profession, but afterwards it was 
accepted by the medical profession because it was found 
to possess some merit, and since then it has been by 
them wonderfully improved, and to-day is recognized 
as a remedial agency of practical utility, and is now in 
quite general use. 

For the foregoing reasons, we believe that if the 
medical profession investigate the work of spinal adjust- 
ment, that this too will be added as another auxiliary, 
and we confidently believe that it will be the greatest 
adjunct that has yet been offered, especially after it has 
been in the hands of and improved by this intelligent 
and able body of physicians, who, we fully believe, will 
not fail to greatly develop and improve it. 

We believe further that the spinal adjustment treat- 
ment in the hands of the ignorant (although the method 
is meritorious) will retrograde and fall, more or less, into 
disuse. 



Preface to First Edition. xi 

Should educated men outside of the medical profession 
espouse and uphold this method, they would establish 
and maintain another distinct system of healing at 
variance with all others, and an incomplete system, 
except surgery, obstetrics, and other things, would be 
added. Another system would only engender confusion, 
and cause loss of confidence and disrespect for the regular 
medical practice or any other system. Let me advise 
you, my fellow-physicians, to obtain and possess every 
potent auxiliary method of treatment, and the confidence 
of the laity will be retained by us and we will be the more 
capable of their full confidence and appreciation. 

Finally, we wish to call the attention of the medical 
profession to one special point concerning the adapta- 
bility of spinal adjustment as an auxiliary expedient 
in their general practice. In the use of hydrotherapy we 
of necessity must have considerable facilities in the way 
of bath equipment, that we may apply the different 
methods of application of hot and cold water, and also 
considerable labor and assistance are necessary. 

In the administration of electrical treatment it is 
necessary to have expensive apparatus that requires 
considerable room, and also time and experience to apply 
it with any degree of success. 

Again, osteopathy consists of more than half a hundred 
different methods of procedure and it requires consider- 
able strength and time to apply this treatment to a 
patient. Besides this, much of the work of the osteopath 
is done by routine, without any practical object in view, 
save to follow out the instructions of their educators. 

But in giving spinal adjustment the equipment is 
quite inexpensive and may be prepared at a trifling 
cost and used without any assistance. In spinal 
adjustment the work is very specific. We make no 
move, give no thrust, make no adjustment, except for a 



xii Preface to First Edition. 

specific purpose. Much less physical exertion and labor 
are required, and also very much less time consumed. 

Much more can be accomplished by spinal adjustment 
in from one to two minutes' time than can beaccomplished 
by electricity, hydrotherapy, osteopathy, or any other 
auxliary system in an hour's time. 

This advantage, we feel, will cause the work of spinal 
adjustment to appeal much more to the practitioner 
than the other cumbersome and laborious adjuncts just 
mentioned. 

We believe that the greatest work of the author's life 
will be to assist in making a humble contribution to the 
knowledge of the medical fraternity, that will aid us in 
our work of relieving pain and suffering, and in this way 
contribute to the welfare of the laity, who look to us for 
the care of their health and the prolongation of their 
existence. 

ALVA A. GREGORY, M. D. 



PREFACE TO SECOND EDITION. 

THERE is an evident necessity that the physicians 
and surgeons of the present time possess a pro- 
ficient knowledge of the cause, indications, and 
results of spinal lesions, arid also the more effective 
methods of removing them and their effects. 

Lack of a competent knowledge of this subject may 
lead to our humiliation by the work of uneducated per- 
sons, who often obtain successful results in the treatment 
of many diseases, by spinal adjustment, that will not 
yield to our ordinary methods of medical and surgical 
treatment. 

We have reached an age of advancement when it is 
unwise, upon the part of the leaders in the practice of 
the healing art, to ignore or pass without due considera- 
tion, any newly discovered methods of diagnosis or treat- 
ment which are based upon reasonable principles and 
rational methods. 

The true principle of advancement in the healing art 
is to investigate all reasonable methods of treatment, with 
an open mind, and to hold fast to those which are found 
to be good. 

We are aware that erroneous teachings, concerning 
the science and philosophy of spinal lesions and spinal 
treatment, have been a potent cause in driving intelligent 
people to disbelief and even disgust, yet we know there 
is a correct philosophy underlying this science, and that 
there is potency in the remedial agency of spinal adjust- 
ment, and that wonderful results follow its application, 
even though the treatment be given by some with limited 
education and in an empirical way. 

We know that we are in need of auxiliary methods of 
treatment, and this is evidenced by the fact that most 



xiv Preface to Second Edition. 

chronic diseases are not amenable to our ordinary methods 
of medical and surgical treatment, and so-called self- 
limited diseases always run their course; while, under 
spinal adjustment and other rational methods, acute and 
the self-limited diseases, so called, are cut short and 
aborted, and chronic cases recover, which have ever 
been believed to be incurable. 

Our first effort to get this new science or method of 
treatment of spinal lesions before the profession has met 
with unexpected success and we hereby acknowledge our 
gratitude, and we trust in this volume to merit your 
further appreciation and continued support. 

In the preparation of this work we have consulted 
the following works: Gray's Anatomy, Cunningham's 
Anatomy, Clark's Applied Anatomy, Landois' Physiology 
(edited by Brubaker), Spondylotherapy, by Abrams. and 
other text-books. 

We are indebted to many practitioners of spinal 
adjustment, for points on methods of procedure in reliev- 
ing contractions of the musculature of the spine. We 
especially thank Dr. Oakley Smith, Chicago, Illinois, 
Dr. J. Franklin Balzer, Pasadena, California, Dr. Walter 
Harmer, Burlington, Iowa, Dr. J. Alfred Coultrap, Colo- 
rado Springs, Colorado, Dr. George Olsen, Dr. D. Chaliss 
Faust, Philadelphia, Pennsylvania, Dr. P. E. Erickson, 
Salt Lake City, Utah, Dr. George B. Abbott, Los Angeles, 
California, and others, for methods of adjustment, and 
to those mentioned and others we are indebted for many 
of the methods described and illustrated in this work. 

We especially call your attention to a new feature of 
spinal treatment by spinal percussion. This method has 
been used by the Japanese in the resuscitation of persons 
who have recently been made unconscious from accident 
or shock or from heart failure. Dr. Abrams has done 
much investigation and has given us much information 
in his able writings and we are glad that after several 



Preface to Second Edition. xv 

months of investigation that we can concur with him. 
after verifying the truthfulness of his claims by clinical 
experience. 

This work is in line with spinal adjustment and con- 
stitutes one of our most potent auxiliary methods of 
Spondylotherapy, and we are glad to indorse and give 
you briefly much information along this line. 

In our next volume, which is being prepared while 
this work is in the hands of the printers, we wish to give 
more fully the symptoms and the auxiliary methods of 
drugless treatment for acute and chronic disease, believ- 
ing that such a work will be of great value to the prac- 
titioners of rational methods of drugless treatment. 

We wish you to kindly overlook any and all short- 
comings, and to write us your criticisms and to proffer 
us suggestions for improvement in subsequent editions. 

ALVA A. GREGORY, M. D. 



CONTENTS. 

Preface to Part One, First Edition Pages vii to xii. 

Preface to Second Edition Pages xiii to xvi. 

Contents Pages xvii to xxii. 

List of Illustrations Pages xxiii and xxiv. 

Introduction . Pages xxv to xxxii. 

PART ONE. 
Chapter I Pages 3 to 19. 

THE NERVOUS SYSTEM— Phases of nerve function considered- 
Principal divisions of anatomy — Arbitrary divisions of anatomy— Component 
parts of the cerebro-spinal division of the nervous system — The cranial 
nerves: names and function — Regional divisions and number in each — The 
sympathetic division of the nervous system, why so named — Historical 
data — Anatomical — Subdivisions of the sympathetic division of the nervous 
system — The gangliated cords — Cardiac plexus — Solar plexus — Hypogastric 
plexus — Treminal ganglia — Branches . 

Chapter II Pages 20 to 33. 

CONNECTIONS BETWEEN CEREBRO-SPINAL AND SYMPA- 
THETIC DIVISIONS— Color demarcations— White rami to sympathetic- 
White rami to terminal ganglia of the head region — To terminal ganglia of 
pelvic region — Two streams of white rami — Gray rami to cerebro-spinal 
division — Ganglia of the gangliated cords — Gray rami distribution. 

Chapter III Pages 34 to 48. 

THE SYMPATHETIC SYSTEM— The upper portion of the gangliated 
cords — Branches of the superior cervical ganglia and extension — Branches of 
the internal carotid plexus — Cardiac plexus: formation — Terminal ganglia 
given off by the cardiac plexus — Epigastric plexus formation — Terminal 
ganglia given off by solar plexus — Pelvic plexus formation — Terminal ganglia 
given off by pelvic plexus — Spinal action of certain lumbar nerves. 

Chapter IV Pages 49 to 57. 

FUNCTION OF NERVES— Afferent functions— Special senses- 
Intuition — Inspiration — Spinal nerve function control — Cranial function — 
Clinical examples of blindness, deafness, taste, and smell — Subdivisions of 
sense of feeling. 

Chapter V Pages 58 to 65. 

EFFERENT FUNCTIONS OF NERVES— Motor— Mental— Trophic 
—Thermic— Secretory — Excretory — Inhibitory — Subdivisions of motor nerve 
function. 

Chapter VI Pages 66 to 76. 

EFFERENT FUNCTION OF NERVES— Thermic functions— Secre- 
tory organs — Excretory action. 

xvii 



xviii Contents. 

Chapter VII .Pages 77 to 90. 

FUNCTIONS OF THE SYMPATHETIC— Terminal ganglia in organs 
supplied — Functions of the cervical division — Functions of the thoracic 
portion — Function of the pelvic portion — Reflex action — Simple — Co-ordi- 
nated— Tnco-ordinated — Reflex spinal lesions. 

PART TWO. 

Chapter I Pages 91 to 99. 

INTERFERENCE WITH NERVE FUNCTION— Malnutrition- 
Nerve stimulants — Nerve depressants — Mental impressions — Structural 
lesions — Traumatic alterations — Mechanical interference — Effects of fasting — 
Causes of malnutrition — Overfeeding — Underfeeding — Poor digestion — Poison- 
ous food — Poor assimilation — Occlusion of circulation — Impingement of gray 
rami . 

Chapter II . .Pages 100 to 107. 

NERVE STIMULI — Toxins — Medicine — Chemicals — Electricity- 
Mechanical action — Physiological action — Extremes of temperature — 
Mechanical stimuli — Blows — Section — Traction — Pressure — Puncture — 
Crushing — Percussion . 

Chapter III Pages 108 to 115. 

NERVE DEPRESSANTS — Narcotics — Anaesthesia — Compression — 
Lack of oxygen — Cold application — Lack of nutrition — Galvanism (polarizing 
current) . 

Chapter IV Pages 116 to 122. 

MENTAL IMPRESSIONS— Clinical examples— Structural lesions- 
Traumatic alterations — Mechanical interference. 

Chapter V Pages 123 to 132. 

SPINAL LESIONS — Discoveries of Griffith Bros. — Gleanings from early 
literature — Irritation of spinal nerves, by Thomas Brown, M. D. — Statement 
of Dr. Hilton — Clinical example by — Definition of subluxation. 

Chapter VI Pages 133 to 144. 

CAUSES OF SPINAL LESIONS — Jars — Falls — Blows — Strains - 
Settling — Twisting — Muscle tire. 

Chapter VII Pages 145 to 157. 

REFLEX SPINAL LESIONS— Constituents of the reflex cycle— Causes 
of reflex — Burns — Wounds — Strains — Dampness — Irritation — Cold 
draughts — Bacterial infection. 

Chapter VIII Pages 158 to 169. 

RESULTS OF SPINAL LESIONS— Impingement of afferent nerves- 
Impingement of efferent nerves — Impingement of veins from cord — Impinge- 
ment of arteries to cord — Impingement of gray rami to cord — Impingement 
of lymphatics to cord — Impingement of white rami to sympathetic — Lack of 
auto-protection — Lack of normal tonicity — Lack of normal metabolism — 
Lack of normal circulation — Lack of normal recuperation — Lack of normal 
thermogenesis — Lack of histological conformation — How function of nerves 
may be altered. 



Contents. xix 

Chapter IX Pages 170 to 180. 

ETIOLOGY — Pertinent questions — Exciting causes — Exposure' — 
Infection— Traumatism — Errors of diet — Errors of exercise — Poisonous medi- 
cines — Poisonous food stuffs — Some unfavorable results of drug medication. 

Chapter X Pages 181 to 190. 

PREDISPOSING CAUSES OF DISEASE— Pain— Definition— ^ here 
excited — Where produced — Where referred — "W here it exists. 

Chapter XI Pages 191 to 198. 

FEVER — Cause of fever — Source of toxins — Retention — Pacteria — 
Auto-intoxication — How we reduce fever without drugs — Clinical examples. 

PART THREE. 
Chapter I Pages 199 to 228. 

NERVE SUPPLY — Nerve supply to scalp — Nerve supply to brain — 
Nerve supply to nasal cavity — Nerve supply to teeth and gums — Nerve 
supply to the tonsils — Xerve supply to the pharynx — Nerve supply to the 
throat and larynx — Nerve supply to the eyes — Nerve supply to the ear — 
Nerve supply to the tongue — Nerve supply to the thyroid glands. 

Chapter II Pages 229 to 246. 

NERVE SUPPLY TO THORACIC VISCERA— Nerve supply to 
lungs — Nerve supply to the heart — Nerve supply to the diaphragm. 

Chapter III Pages 247 to 267. 

XERVE SUPPLY TO ABDOMINAL VISCERA— Nerve supply to the 
st mach — Nerve supply to the liver — Nerve supply to the spleen — Nerve 
supply to the kidneys — Nerve supply to the small intestines — Nerve supply 
to the large intestines — Nerve supply to the peritoneum. 

Chapter IV Pages 268 to 277. 

NERVE SUPPLY TO PELVIC VISCERA— Nerve supply to the 
uterus — Nerve supply to the bladder — Nerve supply to the prostates — Nerve 
supply to the ovaries and testicles — Nerve supply to the inguinal canal — 
Nerve supply to the rectum — Nerve supply to the genitalia. 

Chapter V Pages 278 to 284. 

CEREBRO-SPINAL CENTERS— Division of cranial nerves— Central 
place in cervical region — Central place in thoracic region — Central place for 
skin action. 

Chapter VI Pages 285 to 294. 

SPINAL CENTERS— Atlas place— Middle cervical place— Arm place — 
Upper heart place — Lung place — Heart place — Stomach place — Central 
place — Liver place — Pancreatic place — Adrenal place — Upper bowel place — 
Lower kidney place — Bladder places — Lower bowel place— Ovaria or testicle 
place — Lower genital place — Rectal place — Relation of spinous processes and 
spinal segments. 



xx Contents. 

Chapter VII. Pages 295 to 302. 

SPINAL CENTERS— Vasomotor centers — Myomotor centers — Vaso- 
constrictor centers — Upper cervical nerves — Middle cervical centers — Lower 
cervical centers — Different dorsal centers— Lumbar centers. 

PART FOUR. 
Chapter I Pages 303 to 313. 

THE NORMAL SPINE— Divisions of spinal column — Average length 
of spinal segments — Parts of a vertebra — Average and uses of the spine — 
Different movements of the spine. 

Chapter II Pages 314 to 324. 

SPONDYLO-SYMPTOMATOLOGY— A neglected subject— Torsion- 
Settling — Lordosis — Kiphosis — Scoliosis — Malalignment — Approxima- 
tion—The evidences of spinal lesions enumerated. 

Chapter III Pages 325 to 334. 

SPINAL EXAMINATIONS— Position for examination— What to note 
in the different positions — General examination in the one position — Enumera- 
tion of the principal symptoms of spinal lesions — Malpositions of the spinous 
processes — Malpositions of the transverse processes. 

Chapter IV Pages 335 to 344. 

SPINAL SUBLUXATIONS— Meaning of the term— Torsion or twisting 
— Anterior, posterior, left and right lateral subluxation — Compound subluxa- 
tion — Approximated condition — Signs of subluxation — Pain — Tender nerves — 
Thermic alterations — Derangement of function — Malalignment of spinous or 
transverse processes — Contracture of spinal musculature. 

Chapter V Pages 345 to 358. 

PALPATION — Pulse rate — Temperature — Spinal lesions — Visceral 
outline — Condition of skin — Local abnormal size — Local abnormal shape — 
Methods of palpation in the cervical region. 

Chapter VI Pages 359 to 378. 

NERVE TRACING— Definition— Methods of holding finger— Methods 
of following a nerve — Tracing from the spine— Tracing toward the spine — 
Locating tender points along nerves — Tracing a peripheral nerve rami — 
Unexplainable nerve tracings in rare cases. 

Chapter VII Pages 379 to 392. 

SPINAL DIAGNOSIS — Definition — Spinal diagnosis helpful — The 
Griffith Bros. — Difficulties in spinal diagnosis — Clinical examples — Spinal 
regions examined. 

PART FIVE. 
Chapter I Pages 393 to 413. 

SPONDYLOTHERAPY METHODS — Stretching -- Swaying — 
Swinging — Manual traction — Bimanual thrust — Vibrato-traction — 
Traction adjustment — Longitudinal vibrato-traction — Mechanical stretch- 
ing, by D. B. Cropp. 



Contents. xxi 

Chapter II Pages 414 to 425. 

MASSEURING — Effect of massage — Increases secretions — Lessens con- 
gestion — Stimulates reflexes — Lightens the work of the heart — Assists peri- 
pheral circulation — Breaks up adhesions — Stimulates absorption — Methods 
of massage. 

Chapter III Pages 426 to 436. 

THERMOTHERAPY— Definition— Effects of hot applications— Direc- 
tions for their use — The cold applications — Nerve pressure — Office equipment 
needed for spondylotherapy. 

Chapter IV Pages 437 to 458. 

ATLAS METHODS— Definition— Improved methods— Atlas methods- 
Ten methods explained — Advantages of each. 

Chapter V Pages 459 to 478. 

CERVICAL METHODS— The old method— T. M. method— The 
rotary method — Flexed finger method — Centrum thrust method — Bimanual 
thrust method — Transverse method — Transverse rotary method — Spinous 
and transverse method. 

Chapter VI Pages 479 to 501. 

UPPER THORACIC METHODS— T. M. method— Lateral method- 
Side thrust methods — Rotary methods — Occipito-spinous methods — Old 
methods — Describing eleven methods in all. 

Chapter VII Pages 502 to 526. 

GENERAL THORACIC METHODS— Describing in this chapter 
fifteen methods of adjustment of the thoracic vertebra. 

Chapter VIII Pages 527 to 551. 

LUMBAR METHODS— Methods of contact— Ulnar contact— Thumb 
contact — Pisiform contact — Hollow of hand contact — Tables used — Bifed 
table — Over roll plan — Raising the limb — Seven methods of lumbar adjust- 
ment described. 

Chapter IX Pages 552 to 566. 

FIFTH LUMBAR METHODS— Lumbar lesions because of shape, 
position, and superimposed weight — Seven methods of adjusting the fifth 
lumbar vertebra described. 



PART SIX. 
Chapter I Pages 567 to 578. 

CRANIAL NERVES — Nerve supply to each and every viscera — 
Cranial nerves — Spinal nerves affect cranial nerves — Description of connection 
of spinal and cranial nerves — Optic nerve — Motor-oculi-ophthalmic ganglia. 

Chapter II Pages 579 to 589. 

CRANIAL NERVES — Trochlear nerves — Trigeminal nerves — Divisions 
of trifacial nerves — Otic ganglia. 



xxii Contents. 

Chapter III Pages 590 to 597. 

CRANIAL NERVES— The abducens nerves— The facial nerves— The 
auditory nerv.s — The glossopharyngeal nerves — The pneumogastric nerves — 
Spinal accessory nerves — Hypoglossal nerves. 

Chapter IV Pages 598 to 619. 

CERVICAL NERVES— Suboccipital nerves— First, second, third, 
fourth, fifth, sixth, seventh, and eighth cervical nerves— Cervical plexus — 
Brachial plexus. 

Chapter V Pages 620 to 637. 

CERVICAL PLEXUS— First, second, third, fourth, fifth thoracic 
nerves — Central place, seventh, eighth, ninth, tenth, eleventh, and twelfth 
thoracic nerves. 

Chapter VI Pages 638 to 649. 

THORACIC NERVES— Lumbar region in general— First, second, 
third, fourth, fifth lumbar nerves. 

Chapter VII Pages 650 to 670. 

LUMBAR NERVES— Origin of the crural nerves— Of the sciatic 
nerves. 

PART SEVEN. 
Chapter I Pages 671 to 683. 

NERVE SUPPLY AND TREATMENT — Diseases of aorta, ankles, 
appendix, bladder, brain, colon, ear, esophagus, extremities, eyeballs, eyelids, 
eyesight, face, fevers, gums, heart, kidneys, larynx, liver, lungs, ovaries, 
pancreas, peritonitis, pharynx, pleura, prostate, rectum, scalp, sex organs, 
small intestines, spleen, stomach, adrenals, teeth, throat, glands, tongue, 
tonsils, uterus. 

Chapter II Pages 684 to 689. 

POINTS OF CONTACT— Thumb contact— Ulnar contact— Pisiform 
contact — Hollow of hand contact — Ball of thumb contact — Folded fingers 
contact . 

Chapter III Pages 690 to 699. 

SPONDYLOTHERAPY METHODS— Specific and simple rules for 
relieving any tender nerve in either the cervical, thoracic, or lumbar region — 
Special rules and precautions to observe in giving the spinal thrust — Rules 
for relieving and preventing spinal soreness and tenderness. 

Chapter IV Pages 700 to 712. 

EXAMINATION OF URINE— Physical characteristics— Solid con- 
tents — Tests for albumin — Test for sugar. 



LIST OF ILLUSTRATIONS. 

Page 

Alva A. Gregory, M. D Frontispiece 

Anatomy of the nervous system 4 

The sympathetic division of the nervous system 11 

Connection between the cerebro-spinal and the sympathetic systems. . . 21 

Spinal cord and gangliated cord 26 

Connection of cervical ganglion with the upper cervical nerves 32 

Thinning of the intervertebral cartilages 130 

Contraction of the ligaments or settling of the spine 131 

Normal intervertebral discs . 137 

Showing an extremely settled condition of the spine 138 

Showing how the nerve sheaths make their exit from the spinal column . 159 

Scheme of the origin and distribution of the spinal nerves 2C0 

Nerve supply of the scalp 202 

Nerve supply of the brain 206 

Nerve supply of the face and neck 209 

Nerve supply of the nasal cavities 211 

Nerve supply of the teeth and gums 213 

Nerve supply of the tonsils 215 

Nerve supply of the pharynx 217 

Nerve supply of the throat and larynx 219 

Nerve supply of the eye 221 

Nerve supply of the ear 224 

Nerve supply of the tongue 226 

Nerve supply of the thyroid body 228 

Nerve supply of the lungs 231 

Nerve supply to the heart 239 

Nerve supply to the diaphragm 243 

Nerve supply of the mammary glands 245 

Nerve supply of the stomach 250 

Nerve supply of the liver 254 

Nerve supply of the spleen 257 

Nerve supply of the pancreas and suprarenal capsules 259 

Nerve supply to the kidneys 261 

Nerve supply of the small intestine 263 

Nerve supply of the large intestine 265 

Nerve supply of the uterus 269 

Nerve supply of the bladder 271 

Nerve supply of the ovary and fallopian tubes 274 

Nerve supply of the rectum 276 

Showing a normal and an abnormal spine . 304 

Showing the exit of the neural sheath 321 

Method of marking tips of spinous process 351 

The tender region in a case of pericarditis 360 

Showing spinal connection' of the tenderness palpated in front 362 

Showing manner of supporting palpating finger in case of nerve tracing . 364 
Showing nerve tracing made in case of rheumatism on front side of arm. 366 

Nerve tracing made in case of rheumatism on back of arm 368 

Showing a nerve tracing in a case of pleurisy. Front view 371 

Showing the spinal origin of the nerves impinged , 373 

Showing the origin and tracing of nerves in a case of blindness 375 

Showing front view of the nerve tracing made in a case of blindness. . . . 377 

Showing the muscles of the neck 387 

xxiii 



xxiv List of Illustrations. 

Page 

Amplia thrill for longitudinal vibrato-traction 404 

Showing patient receiving direct traction 413 

Atlas adjustment (old method) 441 

Bimanual atlas method 443 

Transverse atlas method 445 

Finger pivot atlas method 447 

Bimanual thrust method 450 

Mento-occipital rotary method (sitting) 451 

Mento-occipital rotary (pronate) 454 

Mento-occipital rotary dorsal position 456 

Transverse anterior thrust method 458 

T. M. cervical method 461 

Rotary method 463 

Flexed finger method 465 

Centrum thrust method 467 

Transverse process method 471 

Transverse process (rotary method) 473 

Spinous and transverse method 475 

Transverse occipital bimanual thrust (cervical method) 477 

Our simple adjustment table closed 478 

T. M. Method 481 

Lateral upper thoracic method 483 

Bimanual extension method 485 

Side thrust method 487 

Side thrust method (improved) 489 

Mento-spinous method 491 

Mento-rotary method 493 

Occipito-spinous method 495 

Old upper thoracic method 497 

Occipito-spinous method 499 

Shepherd method No. 1 (patient standing) 505 

Shepherd method No. 2 (patient standing) 507 

Pisiform contact (method No. 4) ' 509 

Rib thrust, thoracic method (Bohemian) 511 

Ulnar border contact (method No. 6) 513 

Spinal swaying (method No. 7) 515 

Hollow of hand contact (patient prone) 517 

Bimanual rotary methods (patient prone) 519 

Thumbs on transverse process (method No. 13) 523 

Ball of thumb contact method 525 

Raising limb, lumbar method 535 

Old method No. 1. Except back end of front table is lower 537 

Side thrust (method No. 2) 540 

Rotary lumbar method No. 4 543 

Rotary lumbar method No. 3 ' 545 

Ilium thrust method No. 6 547 

Ilium thrust method No. 6 549 

Imperfect old method No. 1 555 

Over a roll method 557 

Bohemian fifth lumbar method 559 

Sacral thrust method No. 5 563 

Ramification of nerves 568 

Showing sensory innervation of the anterior part of the body 623 

Showing sensory innervation of the posterior part of the body 625 

Scheme of the distribution of the thoracic spinal nerves 639 

Plan of origin and distribution of a thoracic nerve 643 

Illustration of points of contact 685 



INTRODUCTORY. 

THE ORIGIN OF SPINAL ADJUSTMENT. 

1. The principles underlying the science of spinal 
adjustment are as old as the vertebral column. Prob- 
ably the contraction of muscles and ligaments along the 
spine, when irritated, have ever caused an approximation 
of the vertebrae, which causes a narrowing of the inter- 
vertebral foramina, and consequently an interference 
with the normal nerve supply to the different organs and 
parts of the body. This has been true, undoubtedly, 
to a greater or less extent, from the beginning of the 
human race. 

2. Since the creation of man we have no evidence of 
a change in the histological or anatomical organization 
of the nervous system, nor of the direct or indirect action 
of the same or any organ or part of the body, save a 
diminution in the size of the organic structures and 
functional decrease in strength. 

3. The knowledge of some of the facts concerning 
spinal adjustment and the knowledge of some of the 
principles were partially obtained before the author's 
day. The history of the beginning of this method of 
treatment is largely buried in obscurity. 

4. Although this practice has been in vogue in 
Northern Europe, especially in the Bohemian country, 
for near a hundred years, yet it is even now practically 
unknown in the greater part of the United States. 

5. From Professor Yawger, of the University of 
Pennsylvania, we learned of the use of spinal manipula- 
tion and spinal adjustment by the Germans in their 
fatherland before it was known of or used by the Bohe- 
mians in their native country. 



xx vi Introductory. 

EARLY HISTORY OF SPINAL ADJUSTMENT. 

1. During the past century some of the Bohemians 
have obtained decided constitutional effects and it is 
claimed they have restored many invalids to health by 
their system of giving thrusts and other methods of 
making spinal adjustment. This practice has been in 
Europe, as it has been in the United States so far, with 
few exceptions* in the hands of ignorant and unlearned 
advocates, and consequently is now known to but few of 
those people who are educated in therapeutic lines. 

2. The purpose of the Bohemian manipulations was 
for the relief and cure of disease, both acute and chronic. 
And it is said they have been used also for the purpose 
of resting and refreshing a person after continued tire- 
some labor, and were so used because of exhilarating 
effects that would follow the application of this mode of 
treatment or procedure. 

3. It seems that the promoters of some of the more 
violent sporting games have in some way gained infor- 
mation concerning the effects of spinal treatment. 

For years the football players of America have been 
using a crude and empirical treatment of the spine in 
emergency cases during football games. When a member 
of the team suffered from a jam or blow that would 
knock the breath out of him, four of his comrades would 
take the injured player, one holding to each extremity, 
and stretch him upon the ground, face downward, while 
the fifth party would punch or pound the spinal column 
on either side of the spinous processes, and in this manner 
they would restore his heart action and respiration, or 
relieve the cramping produced by the shock or blow. In 
this way they would soon restore him to the game. 

4. By experience, they learned that this was the 
quickest way to restore a member who had been injured 
or temporarily paralyzed or put out of commission by 



The Origin of Spinal Adjustment. xxvii 

a blow or fall. In a future section of this volume we 
study the action of the nervous system, and we can then 
understand why this method produces quick and positive 
results. 

5. A very crude method of spinal adjustment has 
also been practiced for some time — for the relief of 
sickness, and with great success in many cases — in 
America among some of the emigrants from Northern 
European countries. 

6. The author of this work at one time had a patient 
who was receiving spinal adjustment for lumbago who 
told of the following incident: 

"About twenty years ago I had a Bohemian renter 
on my farm in Minnesota. One day, when I visited him, 
we were talking about sickness, doctors, and medicine. 
He told me he seldom ever called a doctor, nor did he 
use any medicine; and he proceeded to show how, 
when he was sick, he would lay prone upon the floor, 
while his wife would remove her shoes from her feet and 
walk along his spine." In this way she would relieve his 
pain and cramping and the fever, he claimed, by walking 
along his spine from the lumbar to the cervical region. 

In her treatment, one foot would be placed on either 
side of the spinous processes and the application of force 
or weight would be applied to the transverse processes. 

This procedure, no doubt, in a crude way overcame 
ligamentous contractions, which would approximate ver- 
tebrae and narrow the intervertebral foramina, and by this 
they overcame interference with the nerve supply to 
the different organs of the body. 

These people, we are sure, were not familiar with the 
methods of giving thrusts and other methods of treat- 
ment of the spinal column as were used by Napravit, 
who probably, as far as we find any history, was the 
originator of this method of treatment. 

Most of the world's greatest discoveries and many of 



xxviii Introductory. 

nature's great secrets have been brought to light by 
accident or by chance. The true secret of curing disease 
was discovered in this way and by people without pre- 
vious education in therapeutic methods. 

7. Dr. D. Chaliss Faust's recent trip to Bohemia, 
the fatherland of Naprapathy, brought back this most 
interesting bit of history: 

Among the Bohemians many were obliged to carry 
heavy loads on their heads and shoulders or do heavy 
lifting. Sprained backs were common. When such 
occurred, the patient would lie face downward on a 
couch, and the doctor or operator would place his hands 
over the injured and sprained part of the back. But 
instead of giving a rubbing treatment, this Bohemian 
practitioner would deliver a short, quick thrust upon the 
bones themselves. The click (such as you hear and feel 
when you click your knuckle-joints) which followed this 
thrust always brought a most wonderful sense of relief. 
So effective and certain was this "thrust treatment" that 
a rubbing treatment was considered very inferior in 
comparison. So this, then, is the way in which the 
adjusting treatment started. 

But as time went on it was noted that other diseases, 
with which the patient was suffering, were yielding along 
with the strained back. 

Thus was a true secret of curing disease of the vital 
organs brought to light, and no discovery, none excepted, 
is doing more to bring about a complete revolution in the 
healing art than is this one. 

Bohemia is a wonderful country, abounding in many 
interesting and historical objects, but the most interesting 
of all to me was the old historic man under whom I 
studied, Napravit. I had heard much of the old fellow 
during my two years' residence in Cedar Rapids, Iowa, 
amongst the Bohemians, learning what I could of the 
history of Napravit, and every good thing I heard of him 



The Origin of Spinal Adjustment. xxix 

was true. He was called the "Lipony Doctor," and it was 
said that people came to him from miles around and 
were healed of many troubles. 

When I told him his fame had reached as far as 
America, and that I had traveled from across the water 
to study under him, he was much pleased, but took it 
as a matter of course. 

The doctor's name is Pan Jos Vejooda, and he is a 
direct descendant of the original Napravit physician. 
He used to keep books for his father and grandfather, 
and he showed me numerous testimonials dating as far 
back as the year 1840. 

The author believes that this matter is worthy of a 
thorough investigation by the medical profession, because 
of the remarkable effects claimed to be obtained by the 
administration of spinal adjustment. 

Many adjusters, with moderate training and little 
experience, who are now using this method, claim that 
they are very successful in the removal of impinge ment 
or interference with nerves and in the restoration of their 
normal nutrient supply, thus restoring to them their 
normal excitability and their freedom to transfer impulse, 
which they claim restores normal function in previously 
diseased parts of the body. 

BEGINNING OF SPINAL ADJUSTMENT IN 
AMERICA. 

Besides the instances cited above, we have from 
many sources learned of many different crude methods 
of spinal treatment in many places in America before it 
was ever introduced as a school of practice. 

There were some methods tending to adjust spinal 
vertebrae introduced by A. T. Still into a system known 
as Osteopathy. To-day we find that the osteopaths in 
many places are beginning to learn and to use the specific 



xxx Introductory. 

thrust and some of the specific methods of a later school 
of Chiropractic Spondylotherapy. 

The first school established that used the spinal thrust 
exclusively as a system for the treatment of all ailments, 
both acute and chronic, was started by D. D. Palmer, 
who obtained his first ideas of spinal lesions from an 
osteopath by the name of Struthers. The spinal thrust 
we understand he obtained from a Bohemian. Palmer, 
however, established the first school known as Chiro- 
practic, being so named by its founder and to him prop- 
erly belongs the honor, if such be due, of founding a new 
school of practice. We find no evidence whatever that 
he was a discoverer, but find facts to the contrary. 
Palmer being an uneducated man it has fallen to the 
hands of others to develop this science. 

Because of the gross errors taught in this original 
school both by the founder and his successor, many have 
prejudged and condemned this science. Many have felt 
that no important truth could be mixed with so many 
gross errors. 

Some of the medical profession and others of the 
better educated class of people have felt that because 
spinal adjustment was first introduced by a man who 
was wholly uneducated in therapeutic lines, he could 
not have known of any method of much consequence or 
importance as a therapeutic auxiliary; but this dees not, 
by any means, follow. 

Hydrotherapy. — Was established as a cure for 
disease by Priestnitz, an uneducated peasant of Northern 
Europe. The "water cure" has accomplished good in 
the alleviation of disease, both acute and chronic. 

Electrotherapeutics. — Was first recommended and 
used for the relief of disease by men outside of the medical 
profession. It was considered a fraud and by the ignorant 
was thought to be the work of the devil, and it was slow 



The Origin of Spinal Adjustment. xxxi 

in being accepted by the medical profession, as too much 
was claimed for it. 

Both hydrotherapy and electrotherapy, being origi- 
nated and championed by men outside of the medical 
profession and by men uneducated in therapeutic lines, 
were therefore slow in being received. 

The false and extravagant claims made concerning 
their efficacy caused these remedial agents to be branded 
as "fakes" and their reception retarded. After the 
medical men became convinced that there was merit in 
hydrotherapy and electrotherapy they have adopted 
these methods as adjuncts to their therapeutic measures, 
and by their superior education and intelligence have 
greatly developed these agencies of treatment, making 
them much more effective and meritorious. 

Looking forward, we feel sure that when the medical 
world know the value and potency of this new method of 
treatment herein described, they will be glad to use it 
successfully in so many cases where no other method of 
treatment will effect a cure, and that they will appreciate 
the one who has been instrumental in bringing this 
knowledge to their minds. 

We fully appreciate that ignorance and superstition 
have shrouded the meritorious effects of this most potent 
and wonderful method of treatment, and also prevented 
its progress and acceptation by the medical profession. 

We are also hopeful that the present explanation of 
the philosophy of this treatment will be a continuation of 
developments begun by the author, and that this work 
will be a real blessing to our profession and their clients, 
who will be benefited by the use of the rational methods 
herein introduced and described. 



SPINAL 
TREATMENT 



PART ONE. 

NERVOUS SYSTEM AND FUNCTION. 

CHAPTER I. 

ANATOMY OF THE NERVOUS SYSTEM. 

DISEASE is essentially the phenomenon of deranged 
function, and all structural alterations are the 
resulting effects of the deranged function, except 
in cases of traumatism. 

Since all functional activity is the result of nerve 
impulse, the study of deranged function is but an investi- 
gation of the manifestation of disease, and the study of 
histological lesions is but a study of the effects of abnormal 
function. 

Our first and most important consideration in the 
study of disease, is a study of the nervous system, more 
especially from the standpoint of nerve function, but in 
our investigation of the nervous system, we wish to 
study the following enumeration of the phases of nerve 
phenomena and anatomy: 

1. A study of the anatomy of the nervous system. 

2. A study of the nature of nerve function. 

3. Manner of interference with nerve function. 

4. Results of interference with nerve function. 

5. The relief of interference with nerve function. 

6. A study of the distribution and ramification of 

nerves. 

7. Methods of diagnosis from spinal lesions affecting 

nerves. 
We first give our special attention to the general 
anatomy of both the central and peripheral portions of 
the nervous system, throughout all portions of the human 
body. 



Anatomy of the Nervous System. 5 

The student may desire to study only the functional 
activity of the nervous system; or, he may wish to 
study especially the structural arrangement thereof, but 
the study of these two phases of this subject go most 
successfully hand in hand. 

As a basis for the study of the functions of the nervous 
system, we find it necessary to have a comprehensive 
knowledge of the structural formation thereof. 

In the study of the anatomy of man as a whole, we 
consider several phases of the subject. Some of the more 
essential divisions of anatomical study are as follows: 

1. Myology, the anatomy of the muscles. 

2. Osteology, the anatomy of the bones. 

3. Syndesmology, the anatomy of the joints. 

4. Splanchnology, the anatomy of the viscera. 

5. Adenology, the. anatomy of the glandular organs. 

6. Angiology, the anatomy of the blood vessels and 

lymphatics. 

7. Neurology, the anatomy and physiology of the 

nervous system. 

In the diagnosis and treatment of pathological lesions, 
we invite special attention to the last anatomical division, 
namely: Neurology. The first consideration, however, in 
the study of Neurology, is securing a knowledge of the 
anatomy of the nervous system as a basis for the study 
of its functional action. 

The nervous system ramifies all parts of the body. 
There is not an organ, nor a component cell in an organ 
or part of the body, that is not supplied by terminal nerve 
filaments either directly or indirectly. The peripheral 
afferent nerve endings, together with the terminal fibers 
of the efferent nerves, are abundant in all parts of the 
human body. 

The afferent nerve endings are so abundant in the 
surface of the body, that the point of a fine cambric 
needle cannot enter the integument without mechanically 



6 Nervous System and Function. 

injuring a nerve filament, which is evidenced by the fact 
that we always feel an excitation, or more or less painful 
sensation as a result of the prick of a needle, provided 
the excitability of the nerve endings is normal. 

If all the tissues of the body were dissolved away 
except the nervous system, we would have in all the 
peripheral portions of the body a complete outline of 
the human form represented by the terminal peripheral 
branches of the nerve fibers. 

Since the first knowledge necessary to be obtained 
concerning the subject of the nervous system is that of 
its anatomy, we will first consider in a brief way the 
central formation, together with the distribution and 
ramification of the peripheral portions of both the cerebro- 
spinal and sympathetic divisions. 

We realize that the anatomy of the nervous system 
as given in the ordinary text-book, is more or less com- 
plex and obscure. In order to render this subject more 
comprehensive, we will present it from the standpoint 
of its fundamental formation, and gradually work out 
the more minute ramifications, as we find this is the 
most successful way of presenting this subject both in 
lectures and class instruction. 

We recognize the primary anatomical divisions of the 
nervous system, as follows: 

1. The cerebro-spinal division. 

2. The sympathetic division. 

These two parts or divisions of the nervous system are 
not, and should not be considered as two nervous systems, 
but merely subdivisions of one great nervous system. 

THE CEREBRO-SPINAL DIVISION. 

T I 7"E1 will first consider briefly the cerebro-spinal divi- 
* * sion of the nervous system, as to its gross anatomy, 
but will leave the ramification or distribution of nerves 
for subsequent portions of this work. 



Anatomy of the Nervous System. 7 

The cerebrospinal system, through its terminal 
branches, ramifies all portions of the body, and is com- 
posed of the following divisions which are easy to grasp 
and understand : 

I. Brain, or encephalon. 
II. The spinal cord extension. 

III. Twelve pahs of cranial nerves. 

IV. Thirty-one pairs of spinal nerves. 
V. The numerous nerve plexuses. 

VI. The branches of ramification. 
VII. The branches of communication. 

I. The Braix. — The brain is the central portion of the 
nervous system, and is by far the largest accumulation of 
nerve tissue that is found in one location, anywhere in 
the body. 

The brain is the seat or center of life and intelligence, 
and may be considered as the great dynamo that generates 
and furnishes the vital force and consequent activity of 
all the peripheral portions of the nervous system, and 
vitality of the tissues which are supplied thereby. 

II. Spixal Cord. — The spinal cord is the primary 
division of the nervous system, being the first portion 
that is developed in the embryological formation of the 
fetus. 

III. Cranial Xerves. — Twelve pahs of cranial 
nerves are given off from the brain and medulla 
oblongata. The nerves given off from the brain pass 
out of the cranial cavity through bony foramina, and 
are distributed directly to the organs they supply in 
most cases. Xone of the cranial nerves are subject 
to any direct interference by lesions of the spinal 
column. Spinal lesions only affect cranial nerves by 
interfering with spinal nerves supplying communicating 
branches to them. 

The cranial nerves are named according to their 
anatomical formation, and according to their function 



8 Nervous System and Function. 

and the organs they supply, and for this reason their 
names are easily remembered when they are associated 
with the organ controlled by them or with the organ 
which they supply. 

We give the following easy method of remembering 
the names of the cranial nerves. This plan consists of 
remembering a sentence formed of twelve words; and 
the first letter of each word in this sentence is the same 
as the first letter of the name of the corresponding spinal 
nerve. 

The sentence, which is easy to remember, is as follows: 
"On old Monadnock's pointed top a Finn and German 
picked some hops." The first letter of the first word of 
this sentence is "O," and so the first letter of the name of 
the first pair of nerves is "O." The second in this way 
is the same as the first, and so on. We arrange this 
matter as follows, for your convenience: 

I. On Olfactory nerves. 

II. Old Optic nerves. 

III. Monadnock's Motor oculi nerves. 

IV. Pointed Pathetic nerves. 

V. Top Trifacial nerves. 

VI. A Abducens nerves. 

VII. Finn Facial nerves. 

VIII. And Auditory or acoustic. 

IX. German Glosso-pharyngeal. 

X. Picked Pneumogastric. 

XI. Some Spinal accessory. 

XII. Hops Hypoglossal. 

IV. Spinal Nerves. — The spinal nerves are not 
named as are the cranial nerves, but while they are not 
named individually, they are divided into regions, and 
the regional divisions are named as follows: 

1. Cervical. 

2. Thoracic. 

3. Lumbar. 



Anatomy of the Nervous System. 9 

4. Sacral. 

5. Coccygeal. 

There are thirty-one pairs of spinal nerves, with the 
following numbers in the different regions: 
8 pairs of Cervical nerves. 
12 pairs of Thoracic nerves. 
5 pairs of Lumbar nerves. 
5 pairs of Sacral nerves. 
1 pair of Coccygeal nerves. 

V. Nerve Plexuses. — The cranial and spinal nerves 
give off branches, which, in their distribution, com- 
municate with each other, and in this way numerous 
plexuses are formed. This plexus formation constitutes 
the fifth anatomical division of the cerebro-spinal division 
of the nervous system. The formation of the plexuses 
is more conspicuous in some regions than in others. 
For example: 

In the cervical region we have the formation of both 
the cervical plexuses and the brachial plexuses. However, 
the brachial include branches from the upper two or 
three pair of thoracic nerves. 

In the lumbar and sacral regions the spinal nerves 
enter into the formation of plexuses of considerable 
importance, from which are given off the nerves which 
supply the lower extremities. 

VI. and VII. The Branches of Ramification and 
Communication. — The terminal branches of distribution 
that ramify the peripheral tissues of the body, and the 
branches of communication which connect with certain 
portions of the abdominal brain, constitute what is 
known as the branches of ramification and branches of 
communication, and these branches constitute the sixth 
and seventh elementary division of the structural for- 
mation of the cerebro-spinal division of the nervous 
system. 



10 Nervous System and Function. 

THE SYMPATHETIC DIVISION. 

The sympathetic nervous system, sometimes called 
the abdominal brain, or gangliated portion of the ner- 
vous system, is probably less understood generally as to 
its anatomy and physiology than is the cerebro-spinal 
system. 

Even the name of this division of the nervous system 
has been called into question. While anatomists agree 
as to the name of the sympathetic portion of the nervous 
system, others object to its established name. There is 
no doubt that this division of the nervous system was 
so called primarily because of an erroneous belief concern- 
ing the functions of the nervous system. 

Formerly the practitioners of the healing art, before 
the days of our modern and more intelligent physicians, 
believed that there was an intelligence that was responsi- 
ble for the cellular functional activity of the organs and 
parts of the body, and that all the action of the vital 
processes was a result of an intelligence which was the 
motive power for all activity, and with this view as a 
basis upon which to form their conclusions, all reflex 
neuroses such as reflex pain, and also the phenomena of 
metastasis, were explained on the ground of a sympa- 
thetic intelligence. 

Recent physiological demonstrations, however, have 
overthrown the view that an intelligence passes over the 
nerves to wholly control the vital activity, but the 
adherents of the former theories are unlearned as to the 
demonstrations that have been made more recently and 
which have set the medical and intelligent world straight 
concerning this matter. Those who hold to the view that 
nerve action is the phenomena of intelligence should favor 
the name sympathetic system. 

We believe, however, that no more appropriate name 



OF MBES 



CAMTIO plexus 

TO 5TH. NEHVE 
TO 4 TH, NERVE 

LARGE SUPERFICIAL PETROSAL 

VIDIAN— TO-&SCKH.-S- CANGLIOM 
"TO 3 W. NERVE ~^* LAR6E DEEP PETROSAL 
TO QAMQLWMOF PNEUMOOASTRIC 

TO- BRANCHES OF EXTERNAL CAROTID ARTERY 



<£ .CARDIAC BRANCHES FROM PNEUMOOASTRIC 
\ \ \ i AND RECURRENT LARYNGEAL NERVES 

^*» ». K 

42\ I \ 1 

GANGLION OF VVRISBERG 




a hepatic plexus 

cystic plexus 

Castro duodenal ple*us 

PYLORIC PLEXUS 

= gasTric^plexus 
splenic jp lex us 



sTlPERJOR -MESENTERIC PLEXUS 



PELVIC- OR INFERIOR HYPOGAST8IC PLEXUS 



S TH. SACRAL NERVE 



CUCCYGEAL NERVE 



12 Nervous System and Function. 

could be had for this division of the nervous system, and 
for several reasons: 

As follows, it is this portion of the nervous system 
which seems to regulate the automatic action of the 
viscera, the sensations of hunger and thirst, and the 
processes of metabolism throughout the system, and 
from this consideration, "sympathetic system" is a very 
appropriate name for this division of the nervous system. 

We quote in this connection the recorded history 
concerning the discovery and early opinions of the 
sympathetic system. 

It is claimed that the sympathetic was known to the 
Hippocratic school. Hippocrates (460-370 B. C), who 
practiced medicine at Athens, Greece, doubtless saw the 
sympathetic many times, at least in animals, but did not 
interpret its functions. Yet he was one of the first to 
cast aside tradition, which, by the way, still lingers, and 
to practice medicine on a basis of inductive reasoning, 
just as a carpenter takes careful measurements before 
building a house, or as a physicist studies astronomy. 

Erasistratus (340-280 B. C.) believed that all nerves 
arise from the brain and cord, but doubtless did not 
recognize the sympathetic nerves as such. It appears, 
however, that he separated nerves into those of motion 
and sensation. He studied particularly the shape and 
structure of the brain. 

Herophilus (300 B. C), it appears, dissected more 
than all his predecessors, both in man and animals. He 
was the first to distinguish nerves from tendons, which 
Aristotle confounded. Herophilus gave the duodenum 
its name because it is twelve inches or finger breadths in 
length. He, like Erasistratus, distinguished nerves of 
motion from those of sensation, and added a careful 
study of the brain. We all remember his "Torcular 
Herophili," or wine-press. 

Aristotle (384 B. C), who widely dissected animals 



Anatomy of the Nervous System. 13 

while instructing Alexander, the son of King Philip, no 
doubt saw the sympathetic system frequently, yet did 
not interpret its significance, for he confounded tendons 
and nerves. 

B. Eustachius, an Italian anatomist, who died in 
1574, considered that the sympathetic nerves originated 
from the abducens or sixth cranial nerve. It was not 
until the name of Thomas Willis (1622-1675), an English 
physician, appeared in anatomical records, that the 
proper significance of the sympathetic nerves was recog- 
nized. Willis looked on the sympathetic system of 
nerves as an appendage of the cerebro-spinal system and 
represented them as growing from the cerebro-spinal 
nerves. Many neurologists hold the same opinion to-day 
as did the able Willis two hundred and fifty years ago. 
He looked upon the sympathetic nerves as a kind of 
diverticula for the animal spirits received from the brain. 
In 1660, while Sedleian professor of philosophy at Oxford, 
he described the chief ganglia. 

Rene Descartes (1569-1650) was one of the first to 
describe reflex movements from ganglia. 

R. Vieussens (1641-1716), a French anatomist, wrote 
a work entitled "Neurograph" in 1684, in which he 
adopted the views of Willis, that the ganglionic nerves 
were appendages of the cerebro-spinal system. 

Vieussens wrote of the ganglia of the solar plexus. 

Prochaska described the reflex channels. 

Duverney (1643-1730) discovered the ciliary ganglia. 

J. M. Lancisus (1654-1720), an Italian anatomist, 
wrote a monograph on the sympathetic nerves, agreeing 
with the keen Willis as regards structure. His mono- 
graph was entitled "Opera Omnia." Lancisus looked 
upon the sympathetic nerves as a kind of forcing pump 
adapted to propel the animal spirits along the nerves. 

The senior Johann Friedrich Meckel (1714-1774), in 
his "Memories de Berlin," 1745, held views on the sub- 



14 Nervous System and Function. 

ject of the sympathetic nerves similar to those of Willis, 
as did also Johann Gotfried Zinn (1727-1759), in a 
publication in 1753. 

J. B. Winslow (1669-1760), a Dane, professor of 
anatomy in Paris, insisted in his writings on the independ- 
ence of the sympathetic nerves. Since that time writers 
have wavered between the opinions of Winslow (inde- 
pendence) and Willis (dependence) in regard to the 
sympathetic nervous system. Yet up to one hundred 
years ago actual physiologic and experimental data were 
quite limited. Bichat, who widely influenced the ana- 
tomic world, vigorously proclaimed the independence of 
the sympathetic ganglia. 

Hoare wrote a publication in 1772 on the sympa- 
thetic system, entitled "De Ganglia Nervorum." 

Antoine Scarpa (1752-1832), the Italian anatomist 
of "Scarpa's Triangle" fame, wrote an essay on the 
sympathetic system, entitled "De Nerv. Gangl.," in 1779. 
This work of course contained the views of previous 
writers. 

Alexander Monro (Monro secundus, 1733-1817), a 
Scotch anatomist of Edinburgh University, published an 
essay "On the Structure and Function of the Nervous 
Ganglia," in 1783. The later writers analyzed more in 
detail and generalized in a manner superior to that of 
previous writers, yet all agreed or disagreed with Willis 
or Winslow. 

Johann Friedrich Blumenbach (1752-1840), a German 
anatomist, in "Institutes of Physiology," published views 
on the sympathetic nerves in 1786. 

Francois Chaussier (1746-1828), a French surgeon 
and anatomist, wrote an "Exposition" of sympathetic 
nerves in 1807. 

In 1812 Le Gallois wrote "Sur le Principe de la Vie," 
containing views on the sympathetic nerve. 



Anatomy of the Nervous System. 15 

In 1823 views of the sympathetic nerve appeared in 
Beclard's "El. d'Anat. Gen." 

Georges Cuvier (1769-1832), a famous French natu- 
ralist, espoused the doctrine of the independence of the 
sympathetic nervous system as published in his "Lecons 
d'Anat. Comp.," 1799. 

Xavier Bichat (1771-1802), the master intellect of 
his day in Paris, professor of anatomy and physiology, 
the associate and rival of the priestly physician, Pinel, 
may be heard insisting with his accustomed eloquence 
upon the independence of the sympathetic nervous sys- 
tem, as noted in his "Sur la Vie et la Mort," 1802. 
Bichat represented all the ganglia of this system as the 
particular centers of organic life, that not only were all 
the ganglia collectively independent, but that each 
ganglion was independent of every other ganglion, that 
each nerve proceeding from such a ganglion was in a 
great measure independent from that ganglion, and even 
that each point of such a nerve was independent of all 
the rest and consisted of a distinct focus of nervous 
influence. Bichat' s influence is distinctly traceable 
through subsequent writings on the sympathetic system. 

Wilson Philip wrote "On the Vital Functions," in 
1817, analogous to the grand center of animal life. He 
also held views referring to the sympathetic system. 

In Mason Good's work "On the Study of Medicine," 
in 1825, views are expressed in regard to the sympathetic 
nervous system. 

Writers on the sympathetic system became more 
numerous in the period subsequent to 1800. 

Richerand (Phys. 1804) and Gall (Anat. et Phys. du 
Syst. Nerv. 1810), adopted tenets concerning the sympa- 
thetic nervous system similar to those of Bichat. 

Wurtzer in 1817 (De Corp. Hum. Gang.) further 
inculcated Bichat's, Winslow's, and Cuvier's views. 

Broussais, whose name is as indelibly connected with 



16 Nervous System and Function. 

inflammation of the peritoneum as Bichat's is with estab- 
lishing the independence of the sympathetic, describes 
a peculiar kind of sensibility or irritability belonging to 
the sympathetic nerves with which it immediately endows 
all organs destined for nutrition, secretion, and the other 
organic functions, and, by means of its repeated connec- 
tions with the cerebro-spinal system, all organs of the 
body. 

Brachet, in his "Sur les Fonctions du Syst. Nerv. 
Gang.," 1823, in an especial manner, distinctly represents 
the ganglionic system of nerves as the seat of "imper- 
ceptible sensation" and as presiding in an especial manner 
over the several viscera of the body. Byron Robinson, 
though not acquainted with Richerand's and Bichat's 
views, worked out the same views from original studies 
and experiments, but added the idea that the abdominal 
brain (solar plexus) is the chief organizing center of the 
abdominal sympathetic. 

The preceding views are simply some of the chief 
landmarks in the progress of the evolutionary develop- 
ment of the knowledge of the sympathetic nerves, in the 
direction of their function and signification. 

The most significant names among the brilliant 
galaxy of students of the sympathetic nerves are Willis, 
Bichat, Cuvier, Winslow, and Brachet. 

In 1835 articles on the sympathetic nerves began to 
appear from the pen of James George Davy, of London, 
England, which study and writing on the sympathetic 
he continued for about thirty years. In 1858 the same 
author published a book, "On the Ganglionic Nervous 
System." The work is composed of 109 pages, is interest- 
ingly written, and contains about all the real knowledge 
of the subject up to that date (1858). Davy claimed that 
much of his book was original, and doubtless this indus- 
trious worker produced many new views in thirty years 
of labor. Yet Davy, as we view him forty years past, 



Anatomy of the Nervous System. 17 

appears very honest in that he credits the gifted Bichat 
with so many original views and vast conceptions. The 
writer can only hope that readers forty years hence will 
view the present accepted views with similar candor and 
charity. 

The anatomical divisions of the sympathetic system 
are fairly plainly marked, and may be comprehensively 
studied under the following divisions: 
I. Gangliated cords. 
II. The cardiac plexus. 

III. Epigastric plexus. 
IV. Hypogastric plexus. 
V. The terminal plexuses. 
VI. The branches of ramification. 

VII. The branches of communication. 

I. Gangliated Cords.— The two gangliated cords of 
the sympathetic system are the foundation of this division 
of the nervous system. They are situated in front of 
and to the side of the bodies of the vertebrae and in com- 
paratively close relation thereto. 

They extend from the base of the brain above to the 
lower end of the spinal column below. Their upper com- 
missural union is in the ganglion of Ribes above and their 
lower union is in the ganglion of Impar or coccygeal 
ganglion below. 

These cords consist of a series of ganglia connected 
by commissural fibers of both the cerebro-spinal and 
sympathetic rami communicantes. 

The ganglia of the gangliated cord are as follows : 

Three in the cervical region. 

Twelve in the thoracic region. 

Four to five in lumbar region. 

Two to eight in the sacral region. 

The cervical region of the gangliated cords contains 
ganglia on each side as follows: 

1. Superior cervical ganglion. 



18 Nervous System and Function. 

2. The middle cervical ganglion. 

3. The inferior cervical ganglion. 

II. Cardiac Plexus. — The cardiac plexus is situated 
in the thoracic cavity and supplies the viscera that are 
contained therein. 

This plexus is made up of cranial, cervical, and tho- 
racic nerve branches and of gray rami of the ganglia of the 
sympathetic cords. 

This great plexus does not supply the viscera of the 
thoracic cavity by direct ramification but by giving off 
the terminal ganglia which directly supply the different 
organs of this cavity. 

III. Solar Plexus. — The solar or epigastric plexus 
supplies the organs or viscera of the abdominal cavity 
and is made up of branches from different regions of the 
spinal column and from branches of the gangliated cords. 

This great plexus is made up principally of fibers as 
follows : 

1. Branches from the cranial nerves. 

2. Branches from the cervical nerves. 

3. Branches from the lower thoracic nerves. 

4. Branches from the lower thoracic ganglia. 

The solar plexus also gives off terminal ganglia which 
supply the viscera of the abdominal cavity, and they are 
either situated in close relation to the organ they supply 
or within the muscular wall of some of them, as in the 
case of the stomach and the more muscular viscera. 

IV. Hypogastric Plexus. — The hypogastric or pel- 
vic plexus is situated in the pelvic cavity and supplies 
the organs of generation and other organs of the pelvic 
cavity. 

This ganglion is made up of the terminal branches of 
the pneumogastric nerves, branches from the lower 
thoracic nerves, branches from the lumbar and sacral 
nerves, and branches from the gangliated cords of the 
sympathetic system. 



Anatomy of the Nervous System. 19 

This plexus supplies the pelvic viscera by giving off 
terminal ganglia. The terminal ganglia also receive 
branches from the spinal nerves. The terminal ganglia 
are situated in close proximity to the organs they supply 
or within the organ they supply, as in the case of the 
uterus. 

V. Terminal Ganglia. — The terminal ganglia are 
the peripheral ganglia referred to above and that portion 
of the sympathetic system that most directly supplies 
the different viscera of the cavities of the trunk. 

When they are situated within the organ they supply, 
they will for a time maintain the action of the organ after 
it is separated from all other nerve connection, and this 
fact proves that the terminal sympathetic ganglionic cells 
possess the power of functioning for a time independent 
of the other portion of the nervous system, and incident- 
ally disproves the theory of innate intelligence controlling 
all functional activity. 

VI. Branches of Ramification. — The branches of 
ramification are the terminal peripheral rami supplying 
different portions of the body and are given off from the 
terminal and other ganglia and from nerves. 

VII. Branches of Communication. — The branches of 
communication are those branches that connect the differ- 
ent ganglia of the sympathetic system and connect the 
ganglia with different nerves of the same regions, or, in 
other words, the communicating branches are those that 
connect the ganglia with ganglia, and ganglia with nerves, 
and nerves with nerves. 



CHAPTER II. 

CONNECTIONS BETWEEN THE CEREBROSPINAL AND 

SYMPATHETIC DIVISIONS OF THE NERVOUS 

SYSTEM. 

FOLLOWING our brief description of the gross 
component parts of the two primary divisions of 
the nervous system, we will next briefly consider 
the connections existing between them, and their relation 
one to another. This is a very interesting study, and a 
subject that has been studied to a considerable extent, 
but probably not so extensively investigated as we would 
like to see. 

1. The cerebro-spinal division of the nervous system 
and its branches of distribution ramifies all parts, both 
central and peripheral, of the human body. 

2. The branches of communication and distribution 
of the sympathetic division of the nervous system ramify 
every portion of the human anatomy, both central and 
peripheral. 

In this chapter our special investigation will be con- 
cerning what is the connection existing between these 
two divisions of the nervous system, and their relation 
in their ramification of the body. 

The cerebro-spinal system is the fundamental portion 
of the nervous system from the standpoint of functional 
action, if not from its anatomical conformation. There 
is no one part of either division of the nervous system that 
is independent of all other portions of the nervous sys- 
tem. While the brain is the central organ of the nervous 
system, it cannot survive independent of the other por- 
tions of the nervous system. The spinal cord cannot 
retain its power of action or vitality except when con- 
nected normally with the brain. 

20 



ENCEPHALON ok BRAIN 



THE CRANIAL NERVES 

CONNECT WITH THE SYM- 
PATHETIC SYSTEM THROUCH 
THE SUPEPIOR CERVICAL 
GANGLION. 



THE CRANIAL NERVES 

1. OLFACTORY. 

2. OPTIC. 

3. MOTOR OCOLI. 

4. PATHETICUS. 

5. TRIGEMINUS 

6. ABDUCENS. 

7. FACIAL. 

8. AUDITORY 

9. GLOSSO-PHARYNGEAL 

10. PNEUMOGASTRlC. 

11. SPINAL ACCESSORY. 
K. HYPOGLOSSAL. \2 




CONNECTION BETWEEN THE CERE- 
BRO-SPINAL AND THE SYMPA- 
THETIC SYSTEMS AND THE FOR- 
MATION OF THE THREE GREAT 
PLEXUSES OF THE SYMPATHE- 
TIC SYSTEM. 



SU PERIOR CERVIC. GANGLION. 
PHRENIC NERVES. 



MIDDLE CERVIC. GANGLION. 



INFERIOR CERVIC. GANGLION. 



STELLATE GANGLION. 



THE CARDIAC 
PLEXUS. 



THE EPIGASTRIC 



SOLAR PLEXUS 



THE HYPOGASTRIC 



PELVIC PLEXUS. 



NOTE:- THE DOUBLE LINES BETWEEN SPINAL 
AND SYMPATHETIC CORDS REPRESENT WHITE 
RAMI, THE SINGLE LINES GRAY RAMI. 
C.P.: CENTRAL PLACE OF WHITE RAMI, FROM ISTTO, 
5TH. THORACIC IT PASSES UPWARD IN THE 
GANG. CORD, FROM 6TH. THORACIC DOWN AN& 
INCLUDING 2ND. LUMBAR NERVE IT PASSES 
OOWNWARD IN THE GANGLIATED CORD. 



This illustration made after the direction of the author, especially for this work. 



22 Nervous System and Function. 

The abdominal brain, or sympathetic system, is also 
wholly dependent upon its connection with the cerebro- 
spinal system for its vitality and power of action. To 
study the connections existing between the cerebro- 
spinal and sympathetic divisions of the nervous system, 
is somewhat difficult, and I know of no laboratories in 
this country that are equipped for proper and extensive 
investigations along this line, but from different sources 
in our anatomical studies we have been able to gain con- 
siderable information which we are glad to enumerate 
in this connection. 

Color Demarcations. — 

The color of the nerve centers or nerve cells is gray 
in both the cerebro-spinal and sympathetic divisions of 
the nervous system, there is a marked difference in the 
color of the fibers of the communicating and ramifying 
branches of the two divisions of the nervous system 
that is very characteristic and helpful in tracing their 
distribution. 

All the fibers of the cerebro-spinal system are white, 
while the fibers of the sympathetic system are gray. 
The difference in color enables us to distinguish and trace 
the nerve fibers of these two divisions of the nervous 
system as they pass from one division to another. In 
harmony with this distinction in color, anatomists 
term the communicating branches coming from the 
cerebro-spinal system, "white rami communicantes," 
whereas connecting branches from the sympathetic 
system are termed "gray rami communicantes." 

An investigation of the connections existing between 
these two divisions of the nervous system solves a great 
many problems for us as to the source of the nerve supply 
affecting different organs and viscera. In this way we 
are enabled to understand why and how interference with 
cervical and thoracic spinal nerves will alter and decrease 



Cerebrospinal and Sympathetic Divisions. 23 

the function of cranial organs and the organs of special 
sense, as the eyes, ears, and olfactory organs. 

White Rami to Sympathetic. — 

We will first consider the white rami communicantes 
given off by the cerebro-spinal system, and their con- 
nection with the sympathetic system. 

We have in all twelve pairs of cranial nerves, and 
thirty-one pairs of spinal nerves that give off white rami 
communicantes that connect with some portion of the 
sympathetic system, but a limited number of the spinal 
nerves, however, and none of the cranial nerves, nor of 
the sacro-spinal or cervico-spinal nerves, send white rami 
communicantes into the fundamental portions of the 
sympathetic system, namely: The two ganglia ted cords. 

We find a direct connection between all the thoracic 
spinal nerves and the upper two pair of the lumbar 
nerves and the ganglia ted cords, as follows: 

From each pair of spinal nerves, from the first dorsal 
down to and including the second lumbar pair, we have 
white rami communicantes given off by each pair of 
spinal nerves, passing directly to the corresponding 
ganglia of the two gangliated cords of the sympathetic. 

The second pair of thoracic nerves send white rami 
communicantes to the second thoracic ganglia of the 
gangliated cords. The third to the third, the fourth to 
the fourth, and so on in this way down to and including 
the second lumbar. 

The first thoracic pair of spinal nerves sometimes 
does and sometimes does not send white rami communi- 
cantes into the stellate pair of ganglia of the gangliated 
cords. Above the first or second thoracic pair of nerves, 
and below the second lumbar, we find a different distribu- 
tion of the white rami communicantes. 

The white rami communicantes which are given off 
by the cerebro-spinal division of the nervous system in 
the cranial and cervical regions, pass directly into the 



24 Nervous System and Function. 

terminal ganglia of the sympathetic system without 
joining the gangliated cords. 

This is also true of the lumbar nerves below the 
second pair, as they send their white rami, not into the 
gangliated cords, but directly into the terminal ganglia 
of the sympathetic of this region of the body. 

The sacro-spinal nerves also send their communicating 
branches into the terminal ganglia of the sympathetic 
direct, but do not send white rami communicantes into 
the gangliated cords. 

Some of the terminal ganglia that receive white rami 
communicantes from the cranial and cervical spinal 
nerves in the cranial region, we enumerate as follows: 

Spiral ganglia. Carotid ganglia. 

Meckel's ganglia. Bidder's ganglia. 

Tympanic ganglia. Cephalic ganglia. 

Temporal ganglia. Pharyngeal ganglia. 

Vestibular ganglia. Geniculate ganglia. 

Ophthalmic ganglia. Inter-optic ganglia. 

Reticulate ganglia. Infra-maxillary ganglia. 

Submaxillary ganglia. Gasserian or semi-lunar. 

The principal terminal ganglia of the sympathetic 
which receive white rami communicantes from the lumbar 
and sacral nerves, are as follows: 

Vesical plexus. 

Vaginal plexus. 

Uterine plexus. 

Prostatic plexus. 

Plexus Cavernosus. 

Plexus Differential. 

Plexus Hemorrhoidal. 

The terminal ganglia of the sympathetic system which 
are enumerated above, are the terminal ganglia which 
are supplied by the white rami communicantes of the 
cranial and spinal nerves above and below those which 
enter the two gangliated cords. The first enumeration 



Cerebrospinal and Sympathetic Divisions. 25 

embraces the principal ganglia of the sympathetic, which 
are supplied with white rami received from the cervical 
and cranial nerves, while the latter enumeration embraces 
the terminal ganglia of the sympathetic and the pelvic 
region which receive the white rami communicantes from 
the sacro-spinal and lumbo-spinal nerves below the 
second lumbar, which do not send white rami into the 
ganglia ted cords. 

Two Streams of White Rami. — We would call special 
attention to one more point concerning the white rami 
communicantes of the thoracic and upper lumbar regions 
that join the gangliated cords of the sympathetic. We 
notice when the white rami communicantes join the 
ganglia of the sympathetic cords, that portions of the 
fibers behave differently: 

One portion of the white rami joining the sympathetic 
ganglion passes unchanged directly through the ganglion 
they join, to a terminal ganglion of the sympathetic 
system. 

Another portion of the white rami communicantes of 
the spinal nerve, when it joins the ganglion of the gan- 
gliated cord of the sympathetic, arborizes around the cells 
of the ganglion which it joins, and impulses passing over 
these white rami are exchanged to and carried on by 
means of gray rami to final distribution. 

Still other fibers of the white rami join the gangliated 
cord of the sympathetic, and pass unchanged by way of 
the commissural cord to other ganglia of the cord 
above or below the one which they join. We find that 
the white rami are distributed in this way by two streams : 

1. Fibers of the white rami of the upper thoracic 
nerves pass upward into the upper portion of the gan- 
gliated cords, while those of the lower thoracic region, 
joining the lower portion of the gangliated cords, pass 
downward. 

2. It is the upper five or six pair of thoracic spinal 



Illustration showing the spinal cord and a gangliated cord, and connec- 
tions. (Courtesy M. E. Clark.) 



Cerebrospinal and Sympathetic Divisions. 27 

nerves that give off white rami which send part of their 
fibers upward, while the white rami from the lower spinal 
nerves, from the sixth pair down, send their fibers, 
which join the gangliated cords, downward. 

Thus we have the formation of the two streams of 
the white rami communicantes with the dividing point 
between them at the sixth segment of the spinal cord. 
This is one of the anatomical marks which locate what 
we term central place of the nervous system, which is 
the sixth segment of the thoracic region. 

The upward stream of the white rami communicantes, 
or the remainder of their fibers arising from the upper 
thoracic region and passing up the commissural cord of 
the sympathetic, terminate in the superior cervical 
ganglia of the sympathetic, and it is by means of this 
upward stream of these white rami communicantes in 
the gangliated cord of the sympathetic, that the upper 
portions of the gangliated cords are supplied. 

The downward stream of white rami communicantes 
from the lower thoracic region and upper lumbar seg- 
ments which join the corresponding portion of the gangli- 
ated cords, pass downward, and thus the lower portions 
of the gangliated cords of the sympathetic are supplied 
by white rami communicantes. 

This at first would seem to be a peculiar arrangement 
and distribution of the white rami communicantes, but 
a study of the embryological development of the fetus 
seems to offer some explanation of the ultimate arrange- 
ment of the nerve supply of the more distal organs from 
the central place or division of the spinal cord. 

The spinal cord is formed first, and the organs pri- 
marily are formed not in the position and relation they 
are found after perfect development. As development 
progresses, the organs of the lower portion of the trunk 
that are starting to develop near central portions of the 
spinal region, grow downward, while the viscera of the 



28 . Nervous System and Function. 

upper portion of the body pass and grow upward. The 
organs of the pelvic cavity are primarily started in their 
development higher up than they are located after 
development is completed. This fact seems to corre- 
spond with the final arrangement in which the downward 
stream of white rami communicantes from the thoracic 
regions pass or extend downward to supply the organs 
which have passed down during development. 

We have a similar peculiarity of the development of 
the brain and cephalic organs, which tallies in a measure 
with the arrangement of the upward stream of white 
rami from the upper thoracic region. The brain primarily 
begins to develop as small terminal growths on the upper 
end of the spinal cord. At first these protuberances are 
thirteen in number, but as development progresses, we 
find that the thirteen protuberances unite into three 
divisions, namely: The front brain, the mid brain, and 
the posterior brain. 

There is also a development of the different organs 
and parts of the head in the same way, and this fact of 
development corresponds with the upward stream of 
white rami, which we have now learned influences the 
brain and cephalic organs. This phase of our subject 
will be brought out more fully when we take up the 
consideration of the nerve supply to the different organs 
and parts of the body. 

Gray Rami to Cerebro-Spinal Nerves. — 

We now turn our attention to the reverse connection, 
namely: The connection of the sympathetic system with 
the cerebro-spinal by means of gray rami communicantes. 
This connection is more simple and more easily com- 
prehended. 

First, we have in the gangliated cords of the sympa- 
thetic, ganglia as follows: 

1. Three pairs of ganglia in the cervical region. 

2. Twelve pairs of ganglia in the thoracic region. 



Cerebrospinal and Sympathetic Divisions. 29 

3. Four or five pairs of ganglia in the lumbar region. 

4. Two to eight pairs of ganglia in the sacral region. 
All told, we have from eighteen to twenty-five pairs 

of ganglia of the gangliated cords. On the other hand, 
we have thirty-one pairs of spinal nerves and twelve 
pairs of cranial nerves. 

By investigation we find that the ganglia of the 
gangliated cords send gray rami communicantes into each 
and every pair of the cranial and spinal nerves. As the 
cranial and spinal nerves are forty-three in number, 
while the ganglia of the gangliated cord is much less, 
we find it necessary that some of the ganglia of the gan- 
gliated cords must supply two or more nerves, and this by 
investigation we find to be a fact. 

The pair of superior cervical ganglia of the sympa- 
thetic sends gray rami communicantes into more cerebro- 
spinal pairs of nerves than any other ganglia of the 
gangliated cords, and becomes at once the most important 
portion of the gangliated cords for two reasons: 

1. They send ganglia into more pairs of nerves than 
any other. 

2. The superior cervical ganglia is the terminal sub- 
station of all the white rami communicantes of the upper 
stream reaching them from the upper portion of the 
thoracic region. It therefore becomes the great transfer 
station. The superior cervical ganglia send gray rami 
communicantes directly into the spinal nerves, as follows: 

1. The first cervico-spinal pair of nerves. 

2. The second cervico-spinal pair of nerves. 

3. The third cervico-spinal pair of nerves. 

4. The fourth cervico-spinal pair of nerves. 

5. The glosso-pharyngeal cranial nerves. 

6. Pneumogastric cranial nerves. 

7. Hypoglossal cranial nerves. 

From a continuation of the gangliated cords above, 
and from the superior cervical ganglia, we find the gray 



30 Nervous Syste?n and Function. 

rami joining many of the cranial nerves. (See Chapter 
III., page 36.) From the above enumeration we will 
see that the superior cervical ganglia, together with 
the extension of the gangliated cords upward, supply 
sixteen pairs of cerebro-spinal nerves with gray rami 
communicantes . 

The middle pair of cervical ganglia of the sympathetic 
cords send gray rami communicantes into the fifth and 
sixth pair of cervico-spinal nerves, while the inferior 
cervical ganglia in the same manner supply the seventh 
and eighth pairs of cervico-spinal nerves. From this 
point below throughout the thoracic region, the twelve 
pair of ganglia of the gangliated cords of the sympathetic 
system send gray rami into the twelve pair of thoracic 
spinal nerves. 

The first pair of ganglia supply white rami to the first 
pair of thoracic nerves; second to the second, and so on 
through the thoracic region. 

In the lumbar region we have sometimes four and 
sometimes five pair of ganglia of the gangliated cords 
supplying the five pair of nerves. Often one pair of ganglia 
of the sympathetic cord in the lumbar region will send 
gray rami to two pair of the lumbar nerves, and often the 
lumbar nerves receive gray rami from two pair of ganglia 
of the gangliated cords. Hence we have not a uniform 
manner of connection existing between lumbo-spinal 
nerves and the sympathetic ganglia of the cords. 

In the sacral region we have a still greater variance 
in the manner of the connection existing between the 
ganglia of the gangliated cords and sacro-spinal nerves, 
by means of gray rami communicantes. While the sacral 
nerves are uniform in number, the sacral ganglia of the 
gangliated cords vary considerably, and owing to the 
great variation of the number of ganglia in the gangliated 
cords in the sacral region, we would of necessity have a 
variation in the manner of the distribution of the gray 



Cerebrospinal and Sympathetic Divisions. 31 

rami to the sacrospinal nerves. Sometimes we have only 
two ganglia in the sacral portion of the gangliated cords 
joining and supplying five pair of sacral nerves, and one 
pair of coccygeal. In such cases one pair of ganglia must 
supply two or more of the sacral nerves. In other cases 
we have as many as eight pair of ganglia in the sacral 
region of the gangliated cords of the sympathetic, and 
in such cases we find two or three of the ganglia of the 
gangliated cords sending branches to the same sacro- 
spinal pair of nerves. 

Gray Rami Distribution. — 

An important phase of this subject remains for con- 
sideration, and that is the manner of the final distribution 
of the ramifying branches of the gray rami of the gan- 
gliated cords after they have joined the cerebro-spinal 
nerves. 

1. The gray rami accompany the cerebro-spinal nerves 
in their peripheral distribution. 

2. The white rami follow cerebro-spinal nerves back 
to their origin, and thus supply the nerve centers. 

When a gray ramus joins either a cranial or a spinal 
nerve, the fibers divide, one part of which accompanies the 
nerve in its peripheral ramifications, and the other which 
passes to the origin of the nerve, and supplies the nerve 
center in the brain, or in the spinal cord. 

A gray ramus of the gangliated cords of the sympa- 
thetic in the thoracic region, after joining a thoracic nerve, 
really divides its fibers into four divisions: 

1 . One portion going to the posterior primary division 
of the intercostal nerve. 

2. Another division of its fibers goes to the anterior 
primary division of the intercostal nerve. 

3. A division of the fibers goes to the posterior root 
of the spinal nerve. 

4. Another portion of the fibers joins the anterior 
root of the spinal nerve, and thus the gray ramus of the 



32 



Nervous System and Function. 



sympathetic accompanies the intercostal nerve through- 
out its entire zone of peripheral ramification, and it is by 
means of the gray rami which join the intercostal nerves 
and pass back to the cord, that we have a gray rami supply 
to the spinal segment of the origin of the nerve. 

We have a like arrangement of the fibers of distribu- 
tion of the gray rami which join the cranial nerves. The 
gray rami communicantes of the superior cervical ganglia 
of the gangliated cords, or of the continuation of the 
gangliated cords above, unite with all the cranial nerves 
and at the point of this union we have a division of the 




Illustration showing the connection of the superior cervical ganglion of 
the sympathetic system with the upper cervical nerves, some of the cranial 
nerves, and with the internal carotid plexus, which give communicating 
branches to the other cranial nerves. 



Cerebrospinal and Sympathetic Divisions. 33 

gray fibers. A part of them go or accompany the cranial 
nerves in their peripheral ramifications, while the other 
fibers join and extend back to the brain, the centers 
from which these nerves originate. 

By the above arrangement and manner of distribu- 
tion of the gray rami communicantes of the sympathetic 
system, we find them supplying all parts of the human 
body peripherally, and also the central portions of the 
nervous system. 



CHAPTER III. 
THE SYMPATHETIC SYSTEM. 

AS a basis for the further consideration of the func- 
tional activity of the nervous system, we wish to 
consider in more detail the component parts of 
the sympathetic division of the nervous system. We 
wish to outline the formation of this division of the 
nervous system in a new manner, to a great extent, and 
hope by so doing to simplify the subject and make it 
more comprehensive to the reader or student. 

There is no division of anatomy which may be con- 
sidered, that is more important than the study of the 
nervous system. The sympathetic division of the ner- 
vous system has not been studied much by those who 
make a specialty of spondylotherapy, and it is with a 
hope of assisting in this matter that we give the following 
pages to a consideration of this rather abstruse subject. 
We hope, however, that we can give you a mental picture 
of this matter which will be valuable to you. 

In the study of the sympathetic division of the ner- 
vous system, we will begin by investigating the superior 
portions of the gangliated cords; and by this study of 
these portions of the cords in connection with the superior 
cervical ganglia, we are enabled to obtain a comprehensive 
view of the connection of this part of the nervous system, 
with the cranial nerves. 

The portions of the gangliated cords above the supe- 
rior cervical ganglia constitute the extreme upper portions, 
and terminate in the union of the cords in the ganglion 
of Ribes, in which is formed their commissural union. 

The gangliated cords are continued upward from the 
superior cervical ganglia, in a plexiform manner, along 

34 



The Sympathetic System. 35 

and around the external carotid arteries; and continued 
also in the cranial cavity in like manner along the internal 
carotid arteries, and it is from these internal carotid 
portions of the continuation of the gangliated cords, that 
we find their complex relation and communications with 
certain cranial nerves. 

In this connection we will consider the superior 
cervical ganglia. These ganglia are about one and one 
half inches long, about half an inch in width, and about 
one fifth of an inch in thickness. They are situated in 
front of the transverse processes of the second and third 
cervical vertebrae. 

These ganglia are the largest of the ganglia of the 
sympathetic cords, and they are the most important 
ganglia, because of the fact that they act as the great 
transfer station and terminal station of the terminal 
fibers of the upward stream of the white rami communi- 
cantes from the upper thoracic region; and, further, 
because they communicate with so many pairs of cranial 
and cervico-spinal nerves by way of the gray rami 
communicantes . 

The superior cervical ganglia, directly and through 
the fibers coming from them and forming the internal 
carotid plexus, connect with all of the cranial nerves and 
with the four upper pairs of the cervico-spinal nerves. 

The upward streams of the white rami communi- 
cantes from the thoracic segments, which pass upward 
and terminate in the superior cervical ganglia, are, by 
reason of the connections of the superior cervical ganglia 
with the cranial and cervico-spinal nerves, connected 
indirectly with all of those nerves, and it is this connec- 
tion existing between the upper thoracic nerves and 
cranial nerves which enables us to affect the nerve supply 
to the organs of special sense, as we do, by relieving and 
stimulating them by spinal treatment. 



36 Nervous System and Function. 

Branches given off by the superior cervical ganglia: 

1. Branches to cardiac ganglia. 

2. Branches to hypoglossal nerves. 

3. Branches to pharynx and larynx. 

4. Branches to pneumogastric nerves. 

5. Branches to upper cervico-spinal nerves. 

6. Branches to external carotid nerves and plexus. 

7. Branches to internal carotid nerves and plexus. 

Gray rami communicantes from the superior cervical 
ganglia join each of the first four pairs of cervical nerves. 
We see from the above that the gray rami, originating 
in the superior cervical ganglia and in the internal 
carotid plexuses, communicate with all of the twelve pairs 
of cranial nerves, and the upper four pairs of cervico-spinal 
nerves. 

The branches to the ganglia of Nordosum come off 
from the anterior surface of the superior cervical ganglia 
and form communicating branches with the pneumo- 
gastric nerves. The branches to the hypoglossal nerves 
originate from the upper end of the superior cervical 
ganglia and form a direct communication from the 
superior cervical ganglia to the hypoglossal, the twelfth 
pair of cranial nerves. 

The internal carotid plexuses are very important, and 
form the extension of the gangliated cords upward to 
their commissural union in the ganglion of Ribes. The 
internal carotid branches come off from the upper end 
of the ganglia, and they assist in forming the carotid 
plexus. Now these plexuses give off the following 
branches : 

1. To the tympanic nerves. J Superior. 

2. To deep petrosal nerves. ,Inferlor - 

3. Branches to the abducens. 

4. Branches to the trochlear. 

5. Branches to the ocular motor. 



The Sympathetic System. 37 

6. Branches to the ciliary ganglia. 

7. Branches to the ophthalmic nerves. 

The internal carotid plexuses, which are a continuation 
of the gangliated cords of the sympathetic, are very 
important portions because of the gray rami connections 
with so many of the cranial nerves. 

The external carotid nerves are given off from the 
lower anterior portion of the superior cervical ganglia 
of the sympathetic, and they come from the external 
carotid plexuses. 

Gray rami supplying the pharynx and larynx are 
given off from the superior cervical ganglia of the sympa- 
thetic, and they join with communicating branches from 
the pneumogastric nerves on both sides to supply either 
side of the larynx and pharynx. 

The pharyngeal and laryngeal nerves are given off 
together, but they separate to form the two divisions, 
one of which supplies the larynx and the other the 
pharynx. 

The superior, middle and inferior cervical sympa- 
thetic cardiac nerves which are given off by the three 
cervical ganglia of the sympathetic, are very important 
nerves, going directly to and entering into the formation 
of the cardiac plexus which supplies the viscera of the 
thoracic cavity. 

From the above outline of the existing connections 
we have given, it will be seen that any interference with 
the superior cervical ganglia will materially affect the 
function of all the cranial nerves as well as of the upper 
cervical nerves, and will also affect the integrity of the 
nerve supply to the heart. 

The superior cervical ganglia may be affected by 
lesions of the axis and atlas in a mechanical way, because 
of any unevenness of the bodies or transverse processes 
of these vertebrae due to a slight malalignment. 

The most decided interference with the superior 



38 Nervous System and Function. 

cervical ganglia is because of an interference with the 
upper thoracic spinal nerves which supply white rami 
communicantes by means of the upward stream of 
communicating fibers that terminate in the superior 
cervical ganglia. 

From the arrangement of these upward streams of 
the white rami, we are enabled to get some conception 
of how interference with the upper thoracic nerves may 
affect the cranial nerves, and consequently the cranial 
organs, such as the eyes, ears, nose, etc., as well as the 
organs of the tongue and upper portions of the alimentary 
canal. 

Since the gray rami communicantes, joining the cranial 
nerves, distribute part of their fibers back to the brain 
itself, as well as to the peripheral fibers of distribution, 
we may conceive how by an interference with the nerves 
which contribute to the formation of the upper stream of 
the white rami, going to, and terminating in, the superior 
cervical ganglia, may materially interfere with the 
metabolic processes of the substance of the brain, and 
also interfere with the normal functioning of that organ. 

Clinical Proofs. — 

As an example of the effects of interference with the 
source of the white rami joining the superior cervical 
ganglia, we would call attention to one clinical case that 
came under our observation some time since: A young 
man who was taking a business course, was compelled 
to abandon work because of severe pain which was 
affecting the balls of his eyes. He had consulted oculists 
and specialists, but they could give him no help and no 
solution of the cause of his difficulty. 

This young man called at the office of the writer, and 
upon examination we found a contracted condition of 
the spinal column, causing interference with the fifth 
pair of thoracic nerves. From our knowledge of the 
connection of the fifth pair of thoracic nerves by means of 



The Sympathetic System. 39 

gray rami communicantes with the superior cervical 
ganglia, and through this organ with the cranial nerves, 
we at once associated the disturbances in the eyeballs 
with this spinal lesion in the thoracic region. 

We gave a thrust specifically directed to relieve the 
contraction of the musculature of this segment of the 
spine, and the relief from pain in the eyeballs was almost 
immediate. He was given spinal adjustment one week 
and discharged as well, although he had felt no further 
disturbance with the eyeballs after the first treatment. 

Now this relief to the boy was quite mysterious, and 
when he reported at the boarding house, that the doctor 
had given him a punch in the back and relieved his eyes, 
it was quite amusing to those with whom he was asso- 
ciated, who could see no connection between the spinal 
thrust in the middle of the back and the relief given to 
the pain in the eyeball. 

We have proven, beyond doubt, in our clinical experi- 
ence in spinal adjustment, that spinal lesions in the 
cervical region, which interfere with cervico-spinal nerves, 
which send branches into the terminal ganglia of the 
region of the head, cause interference with the functions 
of the cranial nerves; and, further, it has been conclu- 
sively proven by adjustment for the relief of spinal con- 
tractions in the upper thoracic region, causing interference 
with thoracic nerves, which contribute white rami com- 
municantes to the upward streams terminating in the 
cervical ganglia, that removing interference with these 
spinal nerves, positively will relieve functional derange- 
ment of the cranial nerves. 

The demonstration of the above facts by means of 
spinal thrusts for the relief of cervical and spinal nerves, 
also proves that the cranial nerves depend upon the white 
rami communicantes from spinal nerves for their func- 
tional activity. 



40 Nervous System and Function. 

CARDIAC PLEXUS. 

VI J E will now turn our attention for a few moments 
* * to a consideration of the manner of the formation 
of the cardiac plexus by investigating what nerves enter 
into its composition; and, we will also consider the 
terminal ganglia that are given off from it. 

This is a necessary consideration, that we may 
intelligently locate spinal lesions which may affect the 
cardiac plexus and also that we may be enabled to affect 
the organs that are supplied by this plexus. The cardiac 
plexus is made up of nerves originating in the brain, and 
in different portions of the spinal column, which we now 
enumerate : 

Nerves entering into the formation of the cardiac 
plexus: 

1. Phrenic. 

2. Pneumogastric. 

3. Middle cervical ganglia. 

4. Superior cervical ganglia. 

5. The inferior cervical ganglia. 

6. Rami from upper thoracic nerves. 

7. Rami from upper thoracic ganglia. 

Some of the nerves enumerated, originate in, and are 
supplied from the brain direct, while others are supplied 
from the cervical region, and some from the upper tho- 
racic region of the spinal cord. By this arrangement we 
can see that lesions of one region which supply the cardiac 
plexus, do not derange or wholly cut off the nerve supply 
to any important organ. This arrangement of the nerve 
supply of the different viscera of the trunk is general, i. e., 
no organ gets its nerve supply entirely from any one 
segment of the spinal cord or of the brain, but all organs 
are influenced by a nerve supply from several different seg- 
ments; hence, none suffer complete loss of nerve impulse 



The Sympathetic System. 41 

supply because of the derangement or cutting off of the 
supply from any one source. 

In the formation of the cardiac plexus, we have the 
phrenic nerve coming from the middle cervical region, 
the principal portion of it coming from the fourth cervical 
pair of nerves, while the auxiliary branches entering into 
its formation, come from the third or fifth pair of cervical 
nerves. 

The pneumogastric, which enters into the formation 
of the cardiac plexus, originates and comes from the 
brain, being one of the twelve pairs of cranial nerves. 
The pneumogastric nerve is decidedly influenced by 
lesions of the atlas and axis, which may affect the first 
and second cervical pair of nerves, as branches from these 
nerves join the vagus. 

It may seem a little peculiar when we consider how 
we may relieve organs of the head and those of the special 
senses by relieving spinal lesions of the thoracic region; 
and then, again, how we may relieve the organs of the 
thoracic cavity by correcting lesions of the cervical 
region. 

Spinal lesions in the thoracic region, affect the organs 
of the thoracic cavity, because white and gray rami from 
this region enter directly into the formation of the cardiac 
plexus, provided the lesions are of sufficient magnitude 
to interfere with nerves coming out therefrom. 

The cervical ganglia of the sympathetic have a direct 
action upon the heart and lungs, but by what source 
impulses are transmitted to and through these ganglia, 
is not evident, except it be by way of the white rami 
communicantes from the upper thoracic nerves, via the 
upper stream of white rami communicantes. 

The cardiac plexus does not itself connect directly 
with, and supply the organs of the thoracic cavity, but 
given off from the great cardiac plexus we have a nerve 
supply to these organs by means of the different terminal 



42 Nervous System and Function. 

ganglia that are situated in proximity to the viscera 
supplied, or within the walls of the viscera, as in the case 
of the heart. We enumerate below the terminal ganglia 
of the sympathetic system in the thoracic region that 
are formed principally from and are given off by the 
great cardiac plexus: 

1. Esophageal plexus. 

2. Deep cardiac plexus. 

3. Anterior coronary plexus. 

4. Posterior coronary plexus. 

5. Anterior pulmonary plexus. 

6. Posterior pulmonary plexus. 

7. The superficial cardiac plexus. 

The names of the plexuses enumerated above indicate 
the viscera they supply. It is well to remember, first: 

That any spinal or cranial nerves which enter into 
the formation of the cardiac plexus, have an important 
function to fill in maintaining the integrity of the action 
of this great plexus, and of the terminal ganglia that 
are given off from it. 

Second. It is well to remember another fact, which 
is, that any lesions of the spine, affecting nerves from 
any of its segments, which join into the formation of the 
cardiac plexus, will affect the functioning of the organs 
supplied by the cardiac plexus, either directly or through 
the terminal ganglia given off from it. 



THE EPIGASTRIC PLEXUS. 

/ T V HE epigastric, or solar plexus, is an important plexus 
-* or ganglia of the sympathetic system which is 
situated within the abdominal cavity, and supplies the 
viscera contained therein. The zone supplied by the 
solar plexus is the largest anatomical area supplied by 
any of the great ganglia of the sympathetic. The 



The Sympathetic System. 43 

epigastric plexus is made up of nerves from different 
portions of the brain and spinal cord. We enumerate 
below the principal nerves that enter into the formation 
of the solar plexus, as follows: 

1. Phrenic. 

2. Pneumogastric. 

3. Great splanchnic. 

4. Lesser splanchnic. 

5. Smallest splanchnic. 

6. Thoracic nerves rami. 

7. Thoracic ganglia rami. 

The formation of the epigastric, or solar plexus, is 
similar to that of the formation of the cardiac plexus. 
The cranial and cervical nerves which join into the 
formation of the cardiac plexus, join also in the formation 
of the solar plexus. The rami from the lower seg- 
ments of the thoracic region, and the ganglia of the lower 
thoracic portion of the gangliated cords, enter into the 
formation of the solar plexus, while the white and gray 
rami of the upper portion of the thoracic region enter into 
the formation of the cardiac plexus. 

The great splanchnic nerves are given off from the 
fifth to ninth pairs of ganglia of the sympathetic cords. 

The lesser splanchnic nerves are given off from the 
tenth and eleventh pairs of ganglia of the sympathetic 
cords. 

The third, or least splanchnic, comes from the twelfth 
pair of sympathetic ganglia of the thoracic region. 

The dividing line between the formation of the cardiac 
plexus and the solar plexus in the thoracic region, is at 
the sixth thoracic vertebra, and this is another mark 
indicating the central segment of the spinal cord, and the 
central place of the great reflex portion of the nervous 
system. 

The epigastric plexus, like the cardiac plexus, supplies 



44 Nervous System and Function. 

the viscera of the abdominal cavity, principally by giving 
off terminal ganglia to supply the different viscera. We 
enumerate the principal ganglia of the epigastric plexus, 
situated in the abdominal cavity, as follows: 

( Liver. 

1. Cceliac plexus. < Spleen. 

2. Aortic plexus. ( Stomach. 

3. Renal plexus. 

4. Adrenal plexus. 

5. Spermatic plexus. 

6. Mesenteric plexus. 

7. Diaphragmatic plexus. 

The aortic plexus of the terminal ganglia is situated 
in the upper portion of the abdominal cavity, and it 
forms a plexiform arrangement around the abdominal 
aorta. 

The renal and adrenal ganglia supply respectively 
the kidneys and supra-renal capsules and are terminal 
ganglia situated in the lower portion of the abdominal 
cavity. 

The spermatic and mesenteric terminal ganglia supply 
the spermatic cords, and mesentery of the intestines. 

The phrenic, or diaphragmatic, ganglia influence the 
functioning of the diaphragm. 

The cceliac plexus supplies and regulates the action 
of the stomach, liver, spleen, and conjointly with the 
above terminal ganglia, affect the vasomotor action of 
the viscera of the abdominal cavity. 

Now there is one other feature of the nerve supply 
entering into the formation of the epigastric and cardiac 
plexuses which exercises a decided influence upon the 
viscera of these cavities. 

First: We have given off from the spinal nerves 
from the lower segment of the thoracic region, from the 
ninth to the eleventh thoracic nerves, branches which 



The Sympathetic System. 45 

connect with the terminal fibers of the phrenic nerves in 
the adrenal plexuses. Impulses from these segments of 
the spinal cord are carried by the afferent fibers of the 
phrenic nerves from above, and we find that kidney 
diseases are associated with derangement both functional 
and organic, of the heart, and in extreme cases we have 
pleuritic effusions and accumulations in the lower part 
of the lungs associated with spinal lesions affecting the 
nerve supply to the kidney which communicates with 
the terminal fibers of the phrenics. 

It is a weir recognized fact among physicians generally 
that there is a connection between conditions of the pelvic 
organs and conditions of the brain. Now this can come 
about in two ways: 

First, lesions of the lower thoracic region which 
interfere with nerves whose filaments join the terminal 
branches of the phrenics have an action upon the general 
circulation of the thoracic cavity. 

The circulation of the thoracic cavity has a com- 
pensatory influence upon the circulation of the brain. 
The connection of the lower thoracic nerves with the 
phrenic nerves affects both the circulation of the brain 
and the circulation of the thoracic cavity, when they are 
disturbed by spinal lesions in the kidney region. 

Again, terminal filaments of the pneumogastric mingle 
with branches of the lumbar nerves, in the structures of 
the pelvic plexus. Impulses by way of the lumbar nerves 
when joining terminal filaments of the vagus in the pelvic 
plexus, are carried by the afferent fibers of that nerve 
back to the solar plexus affecting the integrity of the 
functions of the organs of the thoracic cavity. 

The potency of the influence of the connections just 
referred to, are often verified by the phenomena of 
gastric and cardiac functional derangement witnessed in 
clinical examinations. 



46 Nervous System and Function. 

THE PELVIC PLEXUS. 

HP HE pelvic plexus is situated within and supplies the 
* organs of the pelvic cavity. In its formation it 
resembles somewhat that of the cardiac and epigastric 
plexuses, receiving, as it does, fibers from the brain and 
from different segments of the spinal cord. 

We enumerate the different nerves which send 
branches into the formation of the pelvic plexus, as 
follows : 

1. Hypogastric plexus. 

2. Rami of sacral nerves. 

3. Rami of lumbar nerves. 

4. Rami of sacral ganglia. 

5. Rami of lumbar ganglia. 

6. Rami of thoracic nerves. 

7. Terminal branches of vagus. 

The pneumogastric enters the pelvic plexus princi- 
pally through the hypogastric plexus. The hypogastric 
plexus is a continuation of the solar plexus, and the 
foundation of the formation of the pelvic plexus. It 
forms the connecting link of the fibers of the solar plexus 
with the pelvic plexus, where terminal filaments of the 
vagus connect with filaments from the lumbar nerves. 
This connection solves the problem of why we have 
associated with pelvic disturbances in pregnancy the 
phenomena of gastric disturbances, and also furnishes an 
insight of how lesions of sexual organs cause aberrations 
of the mental faculties. 

Now in the formation of the pelvic plexus we have 
fibers from the brain by way of the vagi, and nerve 
impulses over these nerves may be influenced by spinal 
lesions in the cervical region affecting the first and 
second cervico-spinal pair of nerves which supply com- 
municating branches of the vagi. Also, because of the 
interference with the source of the downward stream of 



The Sympathetic System. 47 

white rami communicantes from the lower thoracic 
region, which has a connection with the pelvic plexus, 
there will be derangement of the function of the organs 
supplied by this portion of the sympathetic. 

The white and gray rami from lumbar and sacral 
nerves enter directly into the formation of the pelvic or 
hypogastric plexus. This plexus, like the solar and 
cardiac plexuses, in their respective zones, supplies the 
viscera of the pelvic cavity principally by giving off 
terminal ganglia, and we enumerate the terminal ganglia 
given off from the pelvic plexus, as follows: 

1. Vesical plexus. 

2. Vaginal plexus. 

3. Uterine plexus. 

4. Prostatic plexus. 

5. Plexus cavernosus. 

6. Plexus differential. 

7. Plexus hemorrhoidal. 

The names of the plexuses enumerated above indicate 
clearly the viscera they supply. It is well to remember 
that while there are nerve filaments from different seg- 
ments of the cerebro-spinal system entering into the 
formation of the great plexuses, as the cardiac, solar and 
pelvic, there are certain nerves that enter more directly 
into these plexuses, or into certain parts of these plexuses, 
and also affect more directly the special terminal ganglia 
that supply the different viscera. 

We might consider, on the one hand, that we have 
an indirect nerve supply, and, on the other hand, a 
direct nerve supply to any one viscus, and the direct 
supply will have decidedly the most influence upon the 
functional activity of the organ supplied. 

For example: The vesical plexus, which is a terminal 
ganglion given off from the pelvic plexus, is influenced 
mostly by the first pair of lumbar nerves, while the 
uterine plexus, which is another one of the terminal 



48 Nervous System and Function. 

plexuses given off from the pelvic plexus, is influenced 
mostly by the fourth pair of lumbar nerves, and the 
same is true of the other plexuses which are formed 
from the pelvic plexus. 

As an example of the influence of the first pair of 
lumbar nerves upon the vesical plexus and the bladder, 
we will call your attention to a case of enuresis. This 
case was called to our attention by a brother physician 
in California. He had recently learned of the effect 
upon the function of the internal organs by spinal treat- 
ment, and after giving one adjustment to a child who had 
been troubled with enuresis for six years, the boy was 
entirely relieved. 

Some of the worst cases of cystitis yield to spinal 
treatment, which overcomes interference with the first 
pair of lumbar nerves. 

The several terminal plexuses of the pelvic region are 
quite decidedly influenced by white rami given off by 
the lumbar and sacral spinal nerves that pass directly 
to and join them. 

Certain lumbar nerves directly influence certain 
terminal ganglia, hence we get more direct and specific 
action upon certain viscera through certain nerves. 

As examples of the above we mention the spinal 
action of the first lumbar nerves upon the bladder. 

The special action of the second pair of lumbar nerves 
upon the colon, appendix, inguinal canal, etc. 

The special action of the third pair of lumbar nerves 
upon the ovaries and testicles. 

The special influence of the fourth pair of lumbar 
nerves upon the uterus. 

The special influence of the fifth pair of lumbar nerves 
upon the rectum and joints of the lower extremities. 



CHAPTER IV. 
FUNCTION OF NERVES. 

HEALTH is essentially a phenomenon of normal 
function, while disease is the phenomenon of 
deranged function. 
Since all function is the result of nerve impulse, the 
study of the function of nerves becomes at once one of 
the most important subjects in connection with health 
or disease. 

A further phase of this subject which lends importance 
to the study of the function of nerves, is the fact that the 
histological condition of all organs and parts of the body 
is dependent upon the processes of metabolism, which 
is entirely governed by nerve function; hence normal 
structural condition is the result of the normal function 
of nerves and the normal metabolic processes. Derange- 
ment, or alteration of the histological elements of any 
organ or part, is caused by a derangement of the processes 
of metabolism, which is due to an interference with the 
nerve supply. 

That property of a living nerve by which it is enabled 
to transmit impulse, is known as "conductivity." As a 
result of the histological arrangement of the motor 
nerves, they are capable of conducting impulses only in 
a centrifugal direction, while sensory nerves are only 
capable of conducting impulses in a centripetal direction. 

Nerves, normally, transmit impulses only in one direc- 
tion, except they may act as inanimate conductors, in 
which case they may conduct in both directions, which 
phenomenon is known as double conduction. 

The difference in the direction in which nerves conduct 
impulses constitutes the primary division of the nervous 
system as to function, namely: Afferent and efferent. 

49 



50 Nervous System and Function. 

The impulse which is conducted by either afferent or 
efferent nerves, we choose to denominate "nerve im- 
pulse," although other names have been applied to this 
phenomenon. By some it has been termed "mental 
force," "mental impulse," or "mental energy," either of 
which may be a proper name for an impulse that arises 
automatically within the brain centers, but would 
naturally be limited in use to when referring to an impulse 
of this nature. 

The term "nerve impulse" is wider in its application, 
and applies to impulses generated by excitation of the 
peripheral endings of the afferent nerves, and will also 
apply to the nerve impulse generated automatically by 
the nerve centers of the brain. 

The afferent nerve action embraces impulses excited 
peripherally by stimuli and conducted centripetally, and 
other receptive functions of the brain, and may be divided 
as follows: 

I. Seeing. 
II. Tasting. 
III. Feeling. 

Afferent Functions: \ IV. Hearing. 

V. Smelling. 

VI. Intuition. 

VII. Inspiration. 

The above classification is not what we have been 
accustomed to in our text-books, as ordinarily we see 
the first five of the above enumeration, classed as special 
senses. This is true; they are special senses, but they 
are also the result of afferent action of nerves, and classify 
correctly as the afferent functions of nerves. 

In enumerating the afferent or receptive powers of 
the nervous system, we embrace not only the five special 
senses, but two other powers of the mind that evidently 
exist, and will classify under the heading, viz., afferent 
function of nerves. 



Function of Nerves. 51 

VI. Intuition. — This is a power of the mind that is 
recognized, and means essentially the capability of the 
mind to know without being taught. It is the automatic 
intelligence which enables birds to build nests, and to 
care for their young without previous instruction. It is 
that power of the mind which enables a pig to return to 
its sty without a guide. Instinct or intuition is that 
power of the human mind by which one is enabled to 
decide questions upon the spur of the moment without 
stopping to reason. 

Instinct is the principal controlling power in a great 
many lower forms of animal life, while reason becomes 
the main controlling power in the higher forms of animal 
life. 



VII. Inspiration.— Inspiration is a knowledge which 
is given us from some source without, and we may not 
know from what source. It is said in the Bible that all 
Scripture was given by inspiration of God. We under- 
stand this to mean that the prophets received their 
instruction from the Holy Ghost. 

Through inspiration we are frequently cognizant of a 
certain fact or facts, when we cannot determine by what 
means or through what medium the knowledge has been 
conveyed to our minds. We have heard of incidents of 
fathers or mothers who would know of the death of a 
son in a foreign land without any conception of the 
source from whence they obtained this knowledge. From 
personal experience I will cite one case as an example of 
this function of the mind. 

The writer had treated a case of tuberculosis, which 
was subsequently, at the time of death, in an adjoining 
State. The evening before the death of this patient we 
had a brief conversation, concerning her, at the dinner 



52 Nervous System and Function. 

table. It was contended by some present that she would 
recover, in time, from her sickness. The next morning, 
as the writer took his seat at the breakfast table, he 
remarked to the crowd assembled there, that this patient 
was dead. 

We knew this was so, but did not know why, nor how 
we knew it. Three days later a paper came from the 
town where the patient resided, which announced her 
death, which had occurred about midnight after the 
dinner at which her case had been discussed. A day or 
two later a letter was received from the sister of the 
patient, who lived several hundred miles further south, 
stating, "I have not heard a word from home; but I 
know that sister is dead." A similar letter came from 
another sister who was living about two hundred miles 
north of the home of the patient. It expressed the same 
sentiment: "I know that sister is dead, although I have 
not heard a word from home." Such cases are too numer- 
ous and too well known to need further citation ; but we 
must concede that there is some source of receiving 
information that is not wholly understood. 

It is well to remember that the term "inspiration," 
which expresses this power of the mind, is broad enough 
in its meaning to embrace functions of this nature, 
whether they be from good or from evil sources. 

The other afferent functions known as the special 
senses, do not need special mention in this connection, 
more than to say that the functioning of the brain in 
any of these channels is responsible for the existence of 
these afferent and receptive powers. 

Any interference with the brain, through circulation 
or otherwise, interferes with these functions. Certain 
centers of the brain seem to preside over the different 
functions enumerated above. 



Function of Nerves. 53 

CRANIAL NERVE FUNCTIONS. 

T T 7E have proven conclusively to our own mind during 
* * the past three or four years, that spinal nerves 
from the cervical and dorsal regions, have a decided, 
positive, and very important effect upon the functioning 
of the cranial nerves or their centers, which are respon- 
sible for the afferent functions of the cranial nerves and 
brain. 

We have restored power of vision to eyes that were 
wholly blind. We have restored power of hearing to ears 
that were almost and sometimes wholly deaf. We have 
restored the function of smell and taste to parties who 
had lost these functions several years previous. 

We have demonstrated the influence of the cervico- 
spinal nerves upon cranial nerves in our clinical experi- 
ences repeatedly, until we have learned to know that the 
optic nerve, auditory nerve, gustatory nerve, and olfac- 
tory nerve and other cranial nerves, will not respond to 
afferent stimulation, nor perform the functions for which 
they are intended, except when the filaments joining 
them, which are given off from the cervical and thoracic 
nerves, are free from interference, and possessing normal 
excitability and perfect conductivity. We will mention 
in this connection some clinical cases which demonstrate 
the correctness of the above statement: 

Blindness. — A druggist, about fifty years of age, had 
suffered the loss of the power of vision in an eye, and this 
was claimed to be due to paralysis of the optic nerve. 
This patient had been under the care of specialists for 
about eight years, when he lost the use of the other eye. 
This left him in total blindness. He applied at our office 
for treatment, and in two or three days' time, the eye 
which had lost the power of vision was sufficiently 
relieved from the lesions causing the trouble, that he 
could appreciate daylight and distinguish objects. Within 



54 Nervous System and Function. 

one week's time he could see his way on the streets and 
could see fairly well even in the dark hallway adjoining 
our office rooms. After a month's treatment he had no 
difficulty in reading the signs along the street, could see 
fairly well, and returned to his home to take charge of 
his drug business. 

Another case which illustrates the effects of spinal 
lesions upon the power of yision or function of the optic 
nerve, was one that the writer treated while on a visit 
to Ocean Grove, New Jersey. This gentleman was about 
fifty years of age, and had suffered a stroke of paralysis 
five years previous to the time he came under the atten- 
tion of the writer. Since the stroke of paralysis he had 
become totally blind in one eye. After a single treatment, 
in which we relieved a contracted condition in the cervical 
region, which affected the middle cervical nerves, he was 
enabled to see daylight, and could even see a postcard 
across the room in his office when he returned to New 
York City the day after the first treatment. Within a 
week's time, vision was restored to the eye that had 
been blind for five years, until this man could recognize 
his friends, the color of their clothing, neckties, etc., 
while the good eye was obstructed or covered. 

Another case which we treated some three years past, 
illustrates the effect of the spinal nerve supply upon the 
visual organs: A minister from an adjoining state 
suffered with very defective vision, in which the area 
of vision was very restricted. He could see only one 
hand of a watch at a time, and it was necessary for him 
to turn the watch around in order to bring the other 
hand into the visual field that he might be able to tell 
the time of day. His vision was acute enough, but the 
field of vision was very much contracted. After one 
week's treatment, he could easily see the face of the 
entire watch, or the face of a clock, at the same instant. 
Before this treatment, in reading signs, he would have 



Function of Nerves. 55 

to read one letter at a time. After one week's treatment 
he could see the whole sign at. the same time. 

We might mention one other case as additional proof 
of the correctness of our statement above concerning 
cervical and thoracic nerves affecting the power and 
function of cranial nerves, but we almost fear to do so 
for fear of inciting disbelief, but "truth crushed to earth 
will rise again." 

A gentleman about thirty-five years of age began to 
lose his eyesight. For a moment he would go blind, but 
vision would return again. This continued for a number 
of days, when one of the eyes failed to recover, but 
remained in -darkness. A few days later the other eye 
went blind and remained so, and the man was left in 
total darkness. He consulted specialists of Oklahoma 
City, but received no encouragement. He was told that 
he would go through life blind. In this condition he was 
brought to the office of the writer. A visiting doctor 
conducted the examination, and gave the first treatment. 
The writer gave the subsequent treatments for a period 
of one week. As a result of the first treatment, the 
power of vision was restored in one eye, until he could 
find the name of the writer in a telephone directory, and 
called to inform him that his eyesight was returning. 
After the second treatment he was enabled to read, with 
either eye, a diploma that hung across the room. After 
a week's treatment he could read the newspapers without 
glasses, notwithstanding the fact that he had worn 
glasses for twenty years before he was stricken blind. 

Deafness. — We have had a variable experience in 
the treatment of deafness by spinal adjustment. Many 
cases of deafness respond very quickly when we relieve 
interference with the nerve supply from the cervical and 
dorsal regions which join and influence the auditory 
nerves. 

There are many cases of catarrhal deafness which 



56 Nervous System and Function. 

will not respond to spinal treatment, or will respond very 
slowly. This seems to be due to the fact of the patho- 
logical changes which have taken place in the inner ear 
as the result of the deranged functional processes asso- 
ciated with catarrh, but the many cases of deafness which 
respond to treatment that is directed toward the relief 
of spinal nerve supply, prove conclusively that these 
nerves have a decided and potent influence upon the 
action of the nerves of this special sense. 

Taste and Smell. — These functions are associated 
more or less closely, and affected practically by the same 
nerve supply. We have learned, by clinical experience, 
that we can restore the sense of taste to those who have 
lost this function, by relieving all interference with 
cervical and thoracic spinal nerves. We have had a 
number of patients who were suffering with anosmia, and 
were void of the sense of taste, and the almost invariable 
result of treatment has been to restore these functions. 
We will cite one case which establishes the correctness of 
this claim: 

An undertaker from Long Island was visiting at 
Ocean Grove, N. J. The writer, who was visiting this 
place at the same time, gave this party one week's spinal 
treatment for the purpose of relieving him of neuras- 
thenia. After a week's adjustment, the party was sur- 
prised to find that he had restored to him the sense of 
taste and smell, functions that he had lost several years 
before. 

Feeling. — The function of the sense of touch or 
feeling is general throughout the body, and is exclusively 
a function of afferent nerves, and it is a known fact to 
clinicians that the acuteness of the sense of feeling depends 
upon the excitability of the nervous system. The loss of 
the sense of feeling is due to paralysis of the nerve supply 
to the zone in which the sensation of feeling is lost. 
Feeling, on the other hand, may be increased above the 



Function of Nerves. 57 

normal, which is also due to a nerve interference, or rather 
to an irritation of the nerves, as in case of inflammation. 
The sense of feeling we divide as follows: 

1. Sense of pain. 

2. Sense of thirst. 

3. Sense of weight. 

4. Sense of hunger. 

5. Sense of pressure. 

6. Sense of pleasure. 

7. Sense of temperature. 

All of the above phases of the sense of feeling are 
alike due to the integrity of the afferent nerve supply, 
and all are deficient in proportion to interference with 
the nerve supply that decreases either the excitability of 
afferent nerves or depresses their conductivity. Inflam- 
matory or excitable conditions of the nervous system will 
magnify these functions. 

As stated above, disease is essentially a phenomenon 
of deranged function. All of the afferent functions of 
nerves which we have considered above, are directly due 
to the condition of the nerve supply. 

Without the nerve function, none of the afferent 
functions would be manifest, and since all of these func- 
tions are controlled by the spinal nerve supply, and as 
at the spine is the place where the nerves are usually 
interfered with, we are at once driven to the conclusion 
that spondylotherapy is the most logical, the most sensible, 
and the most potent treatment for good which has ever 
been brought to the attention of the practitioners of the 
healing art. 



CHAPTER V. 
EFFERENT FUNCTIONS OF NERVES. 

A THOROUGH understanding of the efferent func- 
tional phenomena of the nervous system is very 
necessary to a proper understanding of the effects 
of interference with the nerve supply. 

We now consider the efferent functions of nerves 
briefly. In order to get this subject before us in the 
quickest way, we will enumerate the primary divisions 
of the efferent functions: 

I. Motor. 
II. Mental. 
III. Trophic. 
Efferent Function: { IV. Thermic. 

V. Secretory. 
VI. Excretory. 
VII. Inhibitory. 
Here the same point as was mentioned in the fore- 
going chapter concerning afferent function, might be 
considered with reference to efferent function, namely: 
All function is the result of nerve impulse. Without 
nerve action there would be none of the efferent functions. 
Any interference with nerve supply will interfere with 
the efferent functions enumerated above. 

As the spine is the place where nerves are usually 
interfered with, we are again brought to the conclusion 
that spinal treatment which tends to remove interference 
with the nerves where they are given off from the neural 
canal, is the most rational and most potent treatment 
that has ever been discovered. 

I. Motor. — By this function is meant that character 
of impulse which excites contraction of muscles and other 
tissues. There is no movement of the body, except that 

58 



Efferent Functions of Nerves. 59 

which is produced by muscular contraction. We cannot 
move a hand, nor foot, nor muscle, nor any part of the 
body, without muscular contraction, which is due to the 
motor impulse of the nerve supply. 

Motor function may be divided into the following 
subdivisions: 

1. Myomotor. 

2. Pilomotor. 

3. Vasomotor. 

4. Cardiomotor. 

5. Visceromotor. 

6. Secreto-motor. 

7. Inhibi to-motor. 

In the above division, the names given are those that 
are indicated by the nature of the tissue supplied by 
the motor nerve. 

1. Myomotor. — By the term myomotor we refer 
to motor nerve impulses which affect contraction of the 
muscular tissues in which the nerves terminate. 

2. Pilomotor. — These impulses cause movement of 
the hair by causing contraction of the erectores pilorum. 

3. Vasomotor. — Vasomotor impulses affect the mo- 
bility of the non-striated muscles of the walls of the 
vascular system, and affect the tension of the blood 
vessels, causing vasoconstriction. 

4. Cardiomotor. — By cardiomotor function we refer 
to impulses contracting the muscular walls of the heart. 
A lack of the cardiomotor impulse produces pathological 
conditions, such as dilatation of the heart. 

5. Visceromotor. — Visceromotor impulses control 
the tonicity and peristaltic action of the abdominal 
viscera. Interference with visceromotor function is 
responsible for diarrhea, dysentery, as well as chronic 
constipation. A lack of visceromotor impulses consti- 
tutes a predisposing cause of the invasion of disease, due 
to infections such as typhoid fever and appendicitis and 



60 Nervous System and Function. 

such conditions as hernia and prolapsus of the intestines 
and bowels and other viscera. 

6. Secreto-motor. — By secreto-motor we refer to 
those nerve impulses that produce motor action which 
controls the glandular activity of the body, and the 
glandular secretions of the different mucous and serous 
lining membranes. Any interference of the secreto- 
motor impulses to the nasal cavity, is responsible for 
derangement of the functions of these organs and all 
diseased conditions, and so on throughout all of the 
mucous membranes of the body. 

7. Inhibito-motor. — This is a motor function, or an 
active function on the part of the motor nervous system, 
which controls or regulates the action and all the func- 
tions of the nerves. If it were not for the inhibito-motor 
influences, the reflex action would be increased in amount, 
and all of the reflex response to afferent stimulation would 
result in an excessive reflex response. 

In order to correct interference with any of the phases 
of motor action, it is only necessary to remove all interfer- 
ence with the nerve supply, and that usually necessitates 
the employment of some method of spinal treatment, of 
which spinal adjustment is decidedly the most potent. 

II. Mental. — The mental functions are most interest- 
ing. To the human mind there is no subject more 
interesting than that of the origination of thought and 
all mental function and activity. 

In the first place, there is a very positive relation 
existing between the mind — a non-physical — with the 
brain, a physical organ. 

It is argued by one set of physiologists or psychologists 
that the brain is formed and fashioned by the mind. By 
other anatomists, physiologists and psychologists, it is 
confidently claimed that the mind and all mental faculties 
are originated by, and are the products of, the brain's 
action. 



Efferent Functions of Nerves. 61 

Going further with these divergent views, we might 
compare the relation of brain and the production of mind 
to music produced by different musical instruments, as 
the violin, mandolin, guitar, etc., on the one hand, and 
such an instrument as the seolin harp on the other. All 
of the above instruments are prepared for the production 
of music by stretching cat gut strings over openings in 
specially shaped wooden structures. 

Now the music of the mandolin, violin or guitar, is 
produced by an artist who uses these instruments. The 
musician is the exciting cause and the originator of the 
music, while the instrument is but a tool in his hand. 

With the geolian harp, the instrument is receptive and 
sensitive to breezes or atmospheric pressure, so that from 
moving currents of air different strains of music are 
produced, depending upon the direction, force, and 
velocity of the currents. In this case, the instrument 
becomes the originator of musical sounds, and also the 
producer of music. 

In the first instance we have an intelligence as the 
exciting agency, while in the second instance we have 
the non-intelligent zephyrs from atmospheric movement 
that excite vibrations which produce music. 

Just so certain persons claim there is an entity of 
spirit, an innate intelligence or subconscious mind that 
is separate from, and independent of the brain, and that 
these spirits use the brain as an instrument for the pro- 
duction of thought, while others claim that the brain 
originates and produces thought and all mental action 
as the result of afferent impulses received through the 
different afferent nerve functions, or the brain cells, 
originate thought de novo. 

In one case, the physical brain would be the instru- 
ment, while in the other instance the brain would be the 
agent. It is hard, indeed, to arrive at correct conclusions 
as to the origin of mental manifestations by the study 



62 Nervous System and Function. 

of abstract mental phenomena. Therefore the study of 
the mind cannot be successfully pursued by a study of 
its own operations, or productions, no more than we can 
understand the manner in which a telegram is originated 
and sent by studying the telegram that is received and 
read. 

We may trace the telegraph wire back to its beginning, 
and thus discover the mechanism which generates, and 
the wire which transmits the words of the telegram, so 
we may by an examination and a study of the brain, 
determine something of its component parts and its many 
functions. 

HISTORICAL. 

T>EFORE making an analytical study of brain func- 
^* tions, we feel that it may be of interest to call 
attention of the reader to some of the opinions recorded 
in historical data concerning mind, its location, and its 
connection with the functions of the brain: 

The Babylonians were the first people in the world, 
so far as historical records show, who located the origin 
of the mind within any vital organ. It was thought by 
them that the mind was connected with the liver and 
that it constituted the seat of intelligence. 

We next read of the Hebrews, who considered the 
heart the seat of the soul, and the kidneys the seat of 
the mind, and that all tender emotions originated in the 
bowels. Thus we read in the book of David — the 
Psalms — that "The Lord tryeth the heart and the 
kidneys." 

The prophet Jeremiah upbraids the hypocrites of his 
time, who "had the Lord in their mouths, but not in their 
kidneys." "Bowels of mercy," is an expression of St. Paul 
that we find recorded in the New Testament. 

Other nations of the world seem to have had vague 



Efferent Functions of Nerves. 63 

ideas as to the location of the mind, however. Plato, of 
the Greek nation, claimed that the brain was the supreme 
seat of the mind, but his ideas seemed to be very vague, 
as he confounded the substance of the brain and the 
spinal cord with the marrow of bones. 

Aristotle, however, who was a physiologist, and the 
son of a physician, decided that Plato had evolved in his 
own mind his theory without considering facts that would 
lead to the truth of the matter; he, therefore, decided 
that the brain was an organ for cooling the blood of the 
heart, and that the brain functions had nothing to do 
with the generation of thought or mind. He discovered 
that the brain was apparently an inexcitable and insensi- 
ble organ, while the heart manifested considerable 
excitability; he also was aware of the fact that con- 
sciousness was interfered with by the heated blood of 
fevers, or by blood poisoning, and therefore decided that 
the blood contained the conscious mind, and the heart, 
the central organ of circulation, was the seat of the soul. 

These beliefs held sway for centuries. There were 
many ideas advanced and were extant during these 
centuries concerning the blood, giving to the different 
viscera of the abdominal cavity certain functions, such as 
attributing the appetite and emotions to the liver, spleen, 
stomach, intestines, etc. 

While the dark clouds of ignorance were hanging 
heavily, and while many erroneous views were believed 
and taught, we find a man by the name of Alcmaeon, who 
lived about 500 B. C, teaching that the brain was the sole 
seat of the mind and all motion and feeling. He also 
maintained that sensations were carried to the brain by 
means of nerves. This conclusion was reached by 
experiments in which he had severed the nerves leading 
to and from the brain. 

The views of Alcmaeon, although correct, have, as 
later investigation demonstrated, seemed to be far in 



64 Nervous System and Function. 

advance of the day in which he lived, and his works 
were alluded to by Plato and Aristotle in a contemptuous 
manner. 

Some 300 years B. C, a school of experimental anat- 
omy and physiology arose in Alexandria. Leaders in 
this school dissected the brain, very carefully tracing to 
it the nerves of special sense, and advanced so far as to 
divide the nerves as to functions, into sensory and motor, 
and prepared the way for the final overthrow of the 
doctrine of the brain, as taught by Aristotle. 

Galen, A. D. 160, overthrew the doctrine of Aristotle 
concerning the brain. This physician established the 
doctrine which still survives, i. e., that the brain is the 
seat of thought and mind and feeling. A contemporary 
of his demonstrated that the brain directed muscular 
movements, and made considerable study of the brain 
connection with lesions of paralysis, but he held to the 
old view that the heart was the seat of the soul. 

There seems to have existed in this age of the world 
certain ideas that were a bar to advancement, and to any 
intelligent idea of the brain and its functions. These 
ideas were based upon a knowledge of the then known 
fact, that the arteries were empty after death. The com- 
monly accepted opinion of that day and time was, that 
the arteries were air chambers, and were for the abode 
of spirits which were transferred back and forth from the 
heart to all parts of the body. These opinions as to the 
all-prevailing power of the vital spirits, or intelligences, 
and of functions being produced thereby, was the great 
barrier that for many, many centuries obscured the 
minds of the psychologists and kept the world in ignorance. 

Even to-day these same doctrines are held by some 
psychologists who vary from the view of Hippocrates and 
Aristotle, only in the location or habitat of these spirits 
or intelligences. Instead of the arteries being the channels 
of transition of spirits, as was believed by the ancients, 



Efferent Functions of Nerves. 65 

or, as Descartes attributed to animal spirits, transmitted 
by arteries, and acting upon tissues, all functions, whether 
normal or abnormal, so some of our latter day psycholo- 
gists attribute all function to an intelligence, or sub- 
conscious mind, which they claim is transmitted by, and 
acts through the pathways of the nerves. 

III. Trophic. — The trophic action of nerves is not 
thoroughly understood. The writer fully believes that 
the trophic functions of nerves are due principally to 
that division of the nervous system known as the abdom- 
inal brain, or the sympathetic nervous system, and 
further, we know that the trophic action of nerves is 
purely an involuntary action upon the part of the nervous 
mechanism. 

We do not thoroughly understand the nerve endings, 
nor the manner in which they function, nor their situa- 
tion in the tissues themselves, whose normal metabolism, 
growth, and intact existence they control. 

Considerable work has been done to demonstrate the 
trophic influence of special nerves. Enough has been 
done to prove conclusively that the nourishment and 
repair of all tissues and parts of the body, are directly 
dependent upon the trophic function of nerves. Even 
the growth of bone is known to be influenced by the 
influence of nerve impulse. In fact, all tissues, and even 
the nerves themselves, must be supplied with the trophic 
impulses of nerves, that their existence may be main- 
tained intact — that their action be not impaired or 
destroyed. 



CHAPTER VI. 
THERMIC FUNCTION. 

THE thermic function of nerves is the cause of the 
phenomenon by which potential and kinetic energy 
are made available in the form of caloric heat 
units, which is necessary to the maintenance of the 
uniform temperature in the case of animal life while in 
health, especially those whose temperature is normally 
equitable. 

Chemic changes which are continually taking place 
in the cellular tissues of the living body, are attended by 
the evolution of heat. Potential energy in the nutrient 
substances which we consume, may be appropriately 
designated as latent heat. Mechanical energy and 
electricity are developed from potential energy. 

The processes of metabolic transformation, of a 
chemical nature, of food combinations, reduce or exhaust 
the potential energy contained, from which source is 
derived the mechanical and electric energy. 

All processes of metabolism and all changes occurring 
in the way of heat production, are the direct result of 
nerve impulse, and the nerve impulses, tending to the 
maintenance of the uniformity of the bodily heat, are 
automatically generated in the nerve centers, and aug- 
mented by physical activity and the consequent chemic 
and thermic changes. We affect the bodily temperature 
almost immediately by stimulating the nerve centers, 
which give off the physiological impulses which are 
being continually, automatically originated and given off . 

As examples of the effects of spinal adjustment, we 
copy a short chapter from "Spinal Adjustment" (Gregory) : 

A woman with cold hands came into our office; her 
hands continued cold, notwithstanding the fact that she 

66 



Thermic Function. 67 

was otherwise warm and comfortable. A thrust was 
given to relax the ligaments that were contracted and 
approximating the first and second thoracic vertebrae, 
thereby freeing the first pair of dorsal nerves, and this 
caused the arms to become warm in a few minutes' time. 

Another case which came into our office, was that of 
a lady whose lower limbs had been cold and numb for 
eighteen years, ever since suffering with puerperal fever, 
following her last childbirth. 

She spoke of the condition of her limbs, but voluntarily 
and immediately assured us that we could never cause 
her feet and legs to feel and remain warm again. We 
assured her that we could renew the vital processes in 
those limbs and restore in them a normal thermic condi- 
tion, and after that they would become warm and remain 
so continually. After we had succeeded in relaxing the 
ligaments of the lumbar vertebrae and overcoming their 
contracted and approximated condition, the limbs in 
three days' time became warm and comfortable, to the 
amazement and pleasure of our patient; in fact, there 
was a slight excessive thermic activity and temperature 
in those limbs for several days. 

A young man who was taking spinal adjustment of 
us, came to the office one morning, and upon inquiry 
complained of feeling chilly, but said that this was because 
his blood was thin. After treatment he began perspiring 
gently, and when asked how he felt, he replied that he 
was perfectly warm. The author then asked, "Do you 
know what I have done for you?" The patient replied, 
"No." We then told him we had thickened his blood 
for him. Thus was his idea, that thin blood caused chilli- 
ness, exploded. We had really stimulated thermogenetic 
action and heat production throughout his system, and 
this was responsible for the normal thermogenesis that 
immediately ensued. 

Often during the past three years we have had 



68 Nervous System and Function. 

patients come to us with cold feet and legs, or cold hands 
and arms — either one, or both — and in every case, after 
freeing the spinal nerve supply, the cold extremity would 
again become and remain warm and comfortable. 

All warm-blooded, or homeothermic animals, in all 
latitudes and in all kinds of weather, summer or winter, 
maintain a uniform temperature in all parts of their 
bodies when in a state of health. Now the questions 
arise: How is the necessary heat generated or produced 
in the body? How is the body maintained at a uniform 
temperature? 

At one time a doctor was adjusting a subluxated 
vertebra which was interfering with the spinal nerve 
supply into one arm. As a result of the impingement of 
this nerve, the arm was cold, numb and unnourished. 
When the adjustment was made in the presence of three 
or four persons, for the relief of the nerve, the arm quickly 
became warm. The thermic action set up in this arm, 
and the warmth which ensued, were so marked as to 
excite the immediate attention of the patient, of the 
doctor, and of the witnesses who were present. 

But another phenomenon to be remembered in con- 
nection with this, is, that the other arm, which had, 
previous to this time, been of normal temperature, 
became cold. The subluxated vertebra had been thrown 
laterally a little too far, and while this relieved the 
interference with the nerve which supplied the trophic 
supply and functions of the one arm which had been 
cold, the doctor thereby had caused interference with 
the nerve supply to the other arm, decreasing at once 
the specific and thermic function going on within it. 

The doctor thought for a few moments, and asked 
the persons present what caused the production of heat. 
They answered, "the nerves," and the doctor arrived at 
this same conclusion. This party seems to have reached 
this conclusion because of the fact that when the nerves 



Thermic Function. 69 

are relieved from pressure or impingement, normal 
warmth is restored to a limb or extremity that is supplied 
by this nerve. 

The conclusion was, that the nerve under impinge- 
ment could not heat the limb, and consequently the 
limb became cold. When the nerve was relieved, the 
temperature of that portion of the body at once became 
normal. To the uneducated mind, the conclusion that 
the nerves heat the body, is easily reached, but to the 
better educated, such an idea does not appeal. 

Heat is produced in all portions of the body. The 
larger portion of heat is produced in the muscles; next 
to the muscles in heat production, come the glands, more 
especially the liver. 

The production of heat is under control of the ther- 
mogenetic centers of the nervous system. Nerves con- 
trol the processes of metabolism which liberate the 
stored potential energy in food that is digested and 
assimilated, and hence control or regulate the temperature 
of the body, but do not produce heat per se. 

The maintenance of a uniform temperature of the 
body depends upon the generation of heat keeping pace 
with the heat loss. Both heat production and heat 
loss are variable, but when they keep pace with each 
other, we maintain a normal temperature; but in cases 
of failure of this adjustment, we have either a rise of 
temperature, or fever, or we may have a subnormal 
temperature. 

Nerves are not producers of heat, but control the 
processes of metabolism, which produce and liberate 
heat. The nerves maintain a normal temperature in 
health by heat generated through action they themselves 
produce and regulate. 

The blood is the chief medium of distribution of 
nutrition, carrying the nourishment to all tissues of the 
body. Nerves cannot act or perform any function except 



70 Nervous System and Function. 

they are nourished by the blood stream. If you sever or 
tie, or in any way occlude the artery supplying a nerve, 
you will destroy the action or excitability of that nerve; 
if you then remove the occlusion and restore the nutrient 
supply to the nerve or to its center of origin, you will 
thereby restore the excitability of that nerve or nerves. 
We can then come to but one conclusion, and that is 
what the Bible says: "The blood is the life." Some 
think the blood heats the body — that thin blood causes 
chilliness and inability to withstand exposure to cold, 
except with great discomfort; some think that thick blood 
produces plenty of heat. These ideas are certainly erro- 
neous. This reminds us of the case cited above, of the 
patient who once said to the writer: "I am so chilly, 
and it is because my blood is thin." Soon after his ad- 
justment he felt comfortably warm. Now what caused 
the difference in his feeling so soon? I suggested to 
him that I had thickened his blood; this suggestion 
was in harmony with his idea of being chilly because 
his blood was thin. Now what had I done? I had, by 
giving him an adjustment, stimulated his central ner- 
vous system, and re-established the normal processes of 
metabolism, thereby restoring ample heat production 
throughout his body, and consequently normal warmth 
and comfort. 

Much stress has been laid on chemical action or com- 
bustion going on after eating a diet consisting of free fat. 
This action going on throughout the human organism is 
considered an important agency in heat production. 
Many hold to the idea of the necessity of consuming 
much fat as an article of diet to furnish fuel for combus- 
tion, that the body may, by this means, produce and 
maintain sufficient warmth. Cattle, horses, sheep, and 
all herbivorous animals, maintain a uniform thermic 
condition of their bodies, in all kinds of weather and 



Thermic Function. 71 

during all kinds of exposure, but they do not use as an 
article of diet, any free fat. 

Carnivorous animals, which prefer a meat diet, con- 
sisting of a greater or less extent of fat, do not withstand 
cold any better than (nor as well as) herbivorous animals. 
From the above, students of nature should learn the 
lesson that the consumption of free fat is no indispensable 
assistant in the production and maintenance of normal 
bodily temperature. 

Many think that alcohol and other stimulating drinks 
keep the body warm. They imbibe freely on cold days, 
thinking that by so doing they can better withstand the 
cold weather. Wine is a mocker; those worshiping at 
its shrine are deceived thereby. Under intoxication the 
poor thinks he is rich; the weak thinks he is strong; the 
fool thinks he is wise, and one exposed to cold thinks he 
is remaining warm, when actually his temperature is 
subnormal. Alcohol positively lowers the temperature 
of the body by its benumbing influence upon the nervous 
system, thereby decreasing the excitability and action of 
the thermogenetic afferent nerves and centers. 

The most conclusive evidence of the erroneous views 
which are held concerning the auxiliary effect of fatty 
matter and alcoholic stimulation in increasing heat pro- 
duction, is the experience of the arctic explorers. Explor- 
ers who have used alcoholic stimulants to assist in 
maintaining normal warmth, are lying amidst ice and 
snow in the arctic regions, hidden monuments of common 
ignorance concerning the effects of alcoholic stimulation. 

The free use of fats has also proved to be detrimental 
to the health and welfare of Northern explorers, because 
of the digestive derangement that is engendered by their 
use. The use of free fat in any amount has not only 
proven to be unnecessary, but not as good as other 
nutritious diets not containing free fat, such as plain 
Graham crackers. 



72 Nervous System and Function. 

The free use of coffee is also detrimental to the user 
thereof, if he is to withstand much exposure to cold. 

The use of milk, or any easily digested non-stimulating 
foodstuff not containing free fat, which furnishes nourish- 
ment to the nerves and all other tissues of the body, has 
proven to be the greatest mainstay to mankind in with- 
standing the rigors of the arctic regions. 

The fact that alcoholic stimulation and the free use 
of fats have been abandoned by persons undergoing the 
strain of endurance, while surrounded by frigid temper- 
ature for weeks, is worthy of the consideration of persons 
who have been educated to depend upon the use of free 
fats and toxic stimulation to enable them to withstand 
cold, and is proof conclusive that they are not only 
unnecessary, but detrimental to persons necessarily 
exposed to a low temperature for any length of time. 

V. Secretory. — Secretion is a process by which por- 
tions of the constituents of the blood are separated from 
the blood stream. This process takes place principally 
through the epithelial cells which conduct a flow through 
the walls of the capillary blood vessels. The purposes 
for which the secretions are used, are that of ferments 
for digestion; mucus for lubrication, and also serous 
secretion, as in the pleura and in the peritoneal cavities, 
and in the synovial membranes, as in the joints for the 
prevention of friction. 

The process of secretion is aided by physical forces 
and by diffusion, osmosis, and filtration. We classify 
the secretions as external and internal. 

1. External secretions are such as are used in the 
joints, mucous cavities, and alimentary tract, and in the 
eliminative processes of the body. 

2. Internal secretions are those which are secreted 
principally by ductless glands, and are thrown directly 
into the contents of the blood vessel walls, and exercise 



Thermic Function. 73 

a decided influence upon certain physiological processes 
pertaining to the function of general metabolism. 

The secretory organs are divided into two classes: 
Secreting membranes and secreting glands. 

Internal secretions are productions which are a 
result of the activity of secreting glands, while the 
external secretions are the production of both classes of 
secreting glands, namely: Secreting membranes and 
secreting glands. We classify the secreting membranes 
into three divisions, as follows: 

1. Serous. 

2. Mucous. 

3. Synovial. 

Glandular secretion is from such organs as the 
following: 

1. Liver. 

2. Spleen. 

3. Kidneys. 

4. Pancreas. 

5. Thyroid glands. 

6. Pituitary glands. 

7. Genital glands (testicles). 

VI. Excretory. — Excretion is the process of elimi- 
nation of the end products of tissue metabolism, and 
does not differ essentially in process from the action of 
secretion. The principal excretions of the body are 
urine, perspiration, bile, and carbon dioxide. The 
process of excretion, whether of the skin, liver, or kidneys, 
is wholly under the influence of the automatic or physio- 
logical control of nerve function. 

The physiological influences originate in the central 
portion of the nervous system, and since the action of 
the abdominal brain, or sympathetic system, which 
controls the automatic action, is dependent upon vital 
impulses from the central nervous system, interference 
with spinal nerves which are the channels of distribution 



74 Nervous System and Function. 

of the central impulses, will derange the process of either 
secretion or excretion. 

All function is the production of nerve impulse, and 
there can be no secretion or excretion except it be excited 
through nerve action. The major portion of the phe- 
nomena of nerve action is excited by afferent stimulation, 
and the work done by most of the efferent nerves is but 
a reflex result of the afferent impulse. 

We smell food that is cooking. The afferent nerves 
of the air passages are stimulated thereby, and as the 
result of the reflex excitation of motor nerve endings, in 
the glandular secretory organs, our mouths will water. 
In this case the motor impulse which causes the glandular 
secretion of the saliva, is the result of peripheral stimula- 
tion of the afferent nerves of smell. 

The presence of food in the stomach will reflexly 
excite secreto-motor impulses of the secreting glands 
which furnish the digestive fluids. The alkaline condition 
engendered in the mouth during mastication, acts as a 
special excitant to the afferent nerve endings of the 
stomach, and induce an acid secretion in the stomach 
which is necessary to the action of pepsin upon the food. 

It is the fecal matter in the bowel which stimulates 
the afferent nerve endings in the walls thereof, which 
sets in action the reflex peristalsis and glandular secre- 
tions into the bowel contents. 

When the bladder is filled, it is the presence and 
pressure of its contents upon the sensory terminal nerve 
endings in the bladder which excites the motor impulse 
favoring evacuation. 

In childbirth the fetus becomes the exciting and 
stimulating element which induces the contraction of 
the uterus. The blood is an excitant in the blood vessel 
walls and cavities of the heart, which causes reflex con- 
tractions of the muscles of the heart walls. 

Many of our thoughts and the condition of our mind. 



Thermic Function. 75 

and even the resulting physical condition of the body, are 
influenced by what we see and hear. It is wonderful 
when we study the phenomena of the mind, and the 
result of afferent impressions. 

You may be sitting in your room quietly and hear 
the strain of some old familiar song; it will call you back 
to the days of childhood. You may remember some 
sweet voice in the days of yore, and a train of thoughts 
may rush in upon your mind and tears of joy and tears 
of regret may unbidden start as the result of that afferent 
impression made by the sound of the familiar strain 
through the special sense of hearing. 

The function of the brain may be voluntary or 
involuntary. In voluntary action, the mind originates 
an impulse, which may cause muscular action. It may 
cause us to walk, to write, or to perform any duty. Such 
actions are not directly excited by afferent impulses, yet 
they may be the result of afferent impulses of previous 
occasions. 

Voluntary action is considered as a result of our own 
desires and automatic production of impulse, and there 
may not be any connection between this voluntary 
action and afferent stimulation. Voluntary action is 
wholly of the cerebro-spinal system. It is wholly the 
production of the mental faculties. There can be no 
such thing as voluntary action in the abdominal brain. 

The spinal cord is the great reflex center of the great 
nervous system. The spinal cord, together with the 
sympathetic system, contain and perform the automatic 
control, and the involuntary action which is ever present 
during life. 

VII. Inhibition. — Inhibition is that function of the 
nervous system or of certain centers thereof, which con- 
trols the excitability and action of the nerves regulating 
the involuntary muscular action. 

The function of inhibition may be so greatly increased 



76 Nervous System and Function. 

as to entirely suspend the action of the nerves, responsible 
for involuntary tissue action. The inhibitory action may 
be decreased by depression or paralysis of the inhibitory 
centers, and, as a result, reflex and involuntary action 
may be greatly increased. 

If the nerves transmitting the inhibitory impulses are 
severed, we then experience an entire loss of inhibitory 
control of the involuntary muscles affected thereby. 

We have lack of inhibitory control in chorea, St. Vitus 
dance, and in spasms, fits, and convulsions. 






CHAPTER VII. 
THE SYMPATHETIC SYSTEM. 

THE functions of the sympathetic nervous system 
are an important study. That it is endowed with 
the power of functioning of its own accord, 
entirely independent of the action or influence of other 
portions of the nervous system, is no longer claimed by 
physiologists. 

That the abdominal brain is a component part of the 
general nervous system, and that it is dependent upon 
the central nervous system for its power of action, is 
now generally conceded. 

All the nerve tissues within an animal body are now 
almost invariably regarded as a single nervous system, 
and each component part of the nervous system is 
dependent upon other portions for its vitality and 
functional activity. 

The phenomena of vital function in peripheral 
structures, which are supplied by the gray rami of the 
sympathetic system, will cease immediately after sever- 
ance of the connection of the relative spinal nerves which 
contribute white rami communicantes to the sympathetic 
ganglia, from which the gray rami originate. 

The ganglia of the sympathetic system may, and do, 
for a time, maintain their excitability and functional 
power after being isolated from other portions of the 
nervous system, provided conditions are favorable as to 
temperature, moisture, and nutrition. 

We have many examples demonstrating the excit- 
ability and action of the automatic ganglia of the nervous 
system after the viscera are removed from all spinal 
connections. 

The automatic function of reflex action that is normal 

77 



78 Nervous System and Function. 

during the intact of the entire nervous system, is for a 
time manifest, and acts in the same way in certain 
isolated viscera for a limited time under favorable con- 
ditions. This is true in case of the terminal ganglion 
being within the tissues of the organ supplied. 

It is the existence of such automatic action for a 
limited time that tends to establish beyond a doubt the 
fact that nerve action and response to stimulation is 
independent of any intelligence, mental action or function. 

The functions of the sympathetic nervous system are 
as follows: 

1. Motor. 

2. Trophic. 

3. Secretory. 

4. Excretory. 

5. Inhibitory. 

6. Vasodilator. 

7. Vasoconstrictor. 

Often the vasoconstrictor influence results as a 
primary effect of a stimulation, while the vasodilator 
influence results as a secondary effect of excessive stimu- 
lation. 

The sympathetic system seems to possess independent 
functions in certain organs where the terminal ganglion 
is within the tissues of the organs supplied. We have 
examples of this in the case of ganglia of the 

1. Heart. 

2. Stomach. 

3. Oviducts. 

4. Mesentery. 

5. Lymphatics. 

6. Vas deferens. 

7. Uterine walls. 

Functional action in the parts or organs supplied by 
the terminal cellular tissues of the sympathetic, are 
manifest for a time after severance of the spinal connec- 



The Sympathetic System. 79 

tion, yet their action at all times is influenced by the 
white rami from the spinal nerves. The terminal 
automatic ganglia above mentioned, are partly inhibited 
and stimulated through afferent fibers from the spinal 
nerves and their effects on the efferent nerves. 

The more dependent cellular tissues of the sympa- 
thetic system depend almost wholly upon their connec- 
tion with the cerebro-spinal system for their power of 
functioning, and all the excitability and functional 
activity of these ganglia stop, very soon after being 
severed from their connection with the spine. We have 
examples of this connection with spinal nerves in the 
formation of the splanchnic nerves. The three splanchnic 
nerves receive fibers of white rami communicantes from 
the fifth and twelfth thoracic nerves inclusive, and are 
partly made up from fibers from the relative ganglia of 
the gangliated cords of the sympathetic. 

Functional activity of the fibers of this portion of 
the sympathetic system, seems to be the result of im- 
pulses given off by the spinal nerves, which are taken up 
by the sympathetic cell, around which the white rami 
arborize, and is conveyed from thence by means of gray 
rami to the zone of action. 

Function of the Cervical Portion. — Some study 
has been made of the function of the cervical portion of 
the gangliated cords by the use of stimulants and by 
notation of the effect or action produced in the organs 
supplied. 

The induced electric current used to stimulate the 
central portion of the superior cervical ganglia, will 
induce phenomena such as dilatation of the pupils of 
the eye; contraction of the nictitating membranes of the 
eye; also contraction of the blood vessels of the skin and 
of the mucous membrane; contraction of the nutritient 
vessels of the salivary glands; contraction of the pilo- 



80 Nervous System and Function. 

motor muscles, causing erection of the hair of the head, 
etc. 

If the gangliated cord is divided, then the opposite 
phenomena are induced. If, then, the cut end is stimu- 
lated, we will have a reappearance of the former phe- 
nomena. 

The rami communicantes from the spinal nerves that 
ramify and affect the superior cervical ganglia, are given 
off from the first to the fifth thoracic segments of the 
spinal cord or from the corresponding nerves therefrom. 

The superior cervical ganglia are the transfer or sub- 
stations of the sympathetic for the two upper streams 
of white rami communicantes from the upper thoracic 
segments of the spinal cord. They terminate in the 
superior cervical ganglia, and arborize around the cell 
structures thereof. 

The connection existing between the upper spinal 
nerves and the superior cervical ganglia is by means of 
the white rami which join the gangliated cords, and many 
of these fibers pass unchanged, upward in the cords and 
into the superior cervical ganglia, where they terminate 
by arborization, and where all impulses are transferred 
to and communicated by way of the sympathetic gray 
fibers to the terminal ganglia and to the cranial nerves. 

FUNCTION OF THORACIC PORTION. 

INUNCTION of Thoracic Portion.— The thoracic por- 
■*■ tions of the gangliated cords receive their white rami 
from the relative thoracic nerves. The cervical ganglia, 
and the ganglia of the pelvic region likewise receive their 
white rami from the thoracic nerves principally, by way 
of the two streams of the white rami communicantes. 

For this reason there is a similarity between the 
functions of the cervical, abdominal and thoracic por- 
tions of the gangliated cords of the sympathetic. How- 



The Sympathetic System. 81 

ever, the function of the cervical ganglia, more especially 
the superior cervical, would simulate the functions of 
the thoracic portion, while the pelvic functions would 
simulate those generated by the abdominal portion. 

This is owing to the fact that the thoracic white rami 
joining the thoracic ganglia, are from the same source as 
are the white rami that join the superior cervical; and 
another reason for the similarity of the functions of the 
cervical and thoracic portions of the gangliated cords, is 
the fact that the ganglia given off from the superior 
thoracic portions of the gangliated cords, are partly 
formed by branches coming from the superior, middle, 
and inferior ganglia of the cervical region. Hence, organs 
supplied by the cardiac plexus receive impulses by way 
of both the cervical and the thoracic portion of the 
gangliated cords. 

In the abdominal and pelvic region we have a similar 
condition because of the fact that the white rami of the 
lower thoracic region join both the solar plexus and the 
pelvic plexus. 

Another reason for the similarity of the functions of 
the abdominal portion of the cord and that of the lumbar 
and sacral, is that terminal branches of the pneumogastric 
nerve communicate with rami of spinal nerves in the 
formation of both the solar and the pelvic plexuses. 

By means of the afferent fibers of the pneumogastric, 
impulses are carried in a centripetal direction, and affect 
the efferent fibers and function of the pneumogastric. 
Impulses are carried in a centripetal direction, and affect 
the integrity of the function of this nerve, and in this 
way reflexly affect the heart and stomach. The pneumo- 
gastric from above is joined by gray rami from the 
superior cervical ganglia, and in this way we have an 
influence through the pneumogastric upon the heart, 
lungs, stomach, and abdominal organs. 

There is a variation in the function of the different 



82 Nervous System and Function. 

segments of the thoracic and abdominal sections of the 
spinal cord, and the phenomena produced by stimulation 
varies in different parts. 

The stimulation of spinal centers will excite and 
influence the action on the part of the spinal nerves, and 
also upon the part of the relative ganglia of the sympa- 
thetic cords. This fact is of special interest in spinal 
treatment. Different centers in the cord excite a different 
action upon the viscera, both by acting directly upon 
the terminal ganglia, and by communicating through the 
ganglia of the sympathetic cords. We may cause vaso- 
constrictor influences by stimulation of one center of the 
spinal cord, and may cause vasodilator influences by 
stimulation of other segments of the spinal cord. 

Any one doing spinal treatment may greatly increase 
the potency thereof by having a thorough knowledge of 
the influence of the different spinal centers upon the 
different viscera they desire to affect. This subject will 
be brought out more fully under the head of Spinal 
Centers in a subsequent chapter. 

There is one fact that is well to remember, and that 
is, that in the stimulation of nerve impulse or function of 
nerves, there is always a primary and a secondary effect 
in which the phenomena produced are quite different. 

The primary effect of the stimulation of the thoracic 
ganglia is that of inhibition and vasoconstriction, while 
the secondary effect is that of vasodilation and general 
hypo-tonicity. For the above reason we may excite vaso- 
constriction or vasodilation, and we may also incite 
viscero-motor or viscero-inhibitory action by a stimula- 
tion of the ganglia of the thoracic portions of the sympa- 
thetic cords, which may be done indirectly by a stimula- 
tion of the relative spinal segments. 



The Sympathetic System. 83 

FUNCTION OF THE PELVIC PORTION. 

FUNCTIONS of the pelvic division of the gangliated 
cords are similar to that of the abdominal and tho- 
racic divisions. One fact should always be borne in mind 
in this connection, and that is, that in the pelvic or 
abdominal region, stimulation of the spinal centers is 
inclined to cause vasoconstriction of the blood vessels 
of the viscera above, and to produce vasomotor action 
of the organs and extremities below. 

REFLEX ACTION. 

The word "reflex" means to fly back. By reflex 
action we refer to that phenomena of nerve action in 
which impulses are carried in both directions, both cen- 
tripetal and centrifugal. 

The "reflex arc" consists of an afferent tract, reflex 
center and efferent conduction path of a nerve impulse, 
which is incited as a result of peripheral excitation of 
afferent nerves. 

The study of the subject of reflex action is the most 
important consideration in the study of etiology of 
disease, as well as functional activity that depends upon 
involuntary action of the nervous system, as spinal 
lesions are because of spinal contractions, and deranged 
function is because of disturbance of the excitability of 
nerves, or of the condition of the reflex cycle. The reflex 
phenomena and derangements thereof, are directly respon- 
sible for certain forms of maladies, while the normal 
inhibition and the normal reflexes are responsible for 
normal functioning. 

There are three varieties of reflex movements that are 
recognized : 

I. Simple, or partial reflex. 
II. Extensive co-ordinate reflex. 

III. Extensive inco-ordinate reflex. 



84 Nervous System and Function. 

I. The Simple, or Partial Reflex. — This is when 
the path of the nerve impulse is confined to the normal 
afferent tract and its normal reflex center in the gray 
matter of the cord, and is given off to the corresponding 
efferent fibers affecting one muscle or a certain group of 
muscles. 

The extensive reflex, either co-ordinate or inco- 
ordinate, is a phenomena in which the afferent impulse 
is transmitted from one reflex center in the. spinal cord 
to another, exciting numerous centers and sending out 
impulses over many nerves and exciting the movements 
of a great portion or of the entire body which is due to 
an irritable condition of the spinal centers. 

Every sensory root has its individual spinal center 
and a special reflex path, which offers the least resistance 
to the transition of an afferent impulse, and for this 
reason the tendency is that the afferent impulse is trans- 
mitted and sent back by a corresponding efferent nerve. 

Normally there is more or less resistance against an 
impulse being transmitted from one special center in the 
gray matter of the cord, to others, and this normal 
resistance against impulses from one reflex path, being 
transmitted to adjacent and remote segments, accounts 
for the fact that normal reflex is a simple or partial, and 
the most common phenomenon of reflex action. 

In nature, certain afferent impulses, because of train- 
ing, send impulses back over other nerves. In such cases 
there must be a transfer of the afferent impulse to other 
centers of transition than its own. After sufficient train- 
ing the passing of the impulse from one reflex center to 
another, seems to become a habit, and the transmitted 
reflex action becomes the usual result of the afferent 
impulse. 

The transition of impulses from one center to another 
in the gray matter of the spinal cord, depends upon the 
excitability of the cell tissues of the spinal cord. There 



The Sympathetic System. 85 

are certain medicines that will reduce the excitability of 
the cellular tissues of the gray matter of the spinal column, 
and there are other remedies that will increase the 
excitability of these same centers, and the ability to 
produce a sedative effect upon the spinal centers by 
medication has led to the use of these drugs in the treat- 
ment of certain diseases characterized by an over- 
excitability of the spinal centers. 

The primary effect of anaemia upon the spinal cord is 
to produce an excitable condition of the spinal segments, 
while the secondary effect of absolute anaemia will deprive 
them of any excitability or capability of response to 
stimulation. The transfer of impulses from one center 
to another depends wholly upon the excitability of the 
reflex centers in the gray matter of the cord. The more 
excitable these centers become, the more readily are they 
affected by diffusion of an impulse from one reflex center 
to adjacent and remote centers. 

II. Co-ordinated Reflex Action. — When an im- 
pulse reaches a spinal center and is transmitted to other 
centers producing an action along normal lines in harmony 
with previous training and previous trained action, we 
have what is known as a co-ordinate reflex action. Such 
an action is manifested without any intelligence, and 
even after the reflex centers have been severed from the 
brain and mental centers. 

A decapitated frog will jump when excited by a local 
irritation. In such case reflex phenomena has occurred. 
The local excitation has created an afferent impulse that 
has been transmitted to the centers controlling the motor 
action of the extremities. During the life of this animal 
local irritation has caused a general movement of the 
body out of danger, and this reflex, which seems extra- 
ordinary, is but the result of lifelong training. 

Whenever we have a reflex that is conducted along 
the spine from one center to another which produces 



86 Nervous System and Function. 

action that occurs normally in nature, it is called an 
extensive reflex, but at the same time the phenomena 
is in perfect control and co-ordination, therefore denomi- 
nated a co-ordinate reflex action. We see that manifested 
in life in many ways. The act of walking, running, jump- 
ing, playing the piano, writing on the typewriter, and 
in fact in almost all occupations of life, we have a trained 
co-ordinative reflex action in proportion to the skill that 
is possessed by the operator. 

III. Inco-ordinated Reflex Action. — Inco-ordinate 
reflex is like the co-ordinate, in one respect, because of 
the extension of an impulse from one center in the spinal 
reflex tissues to another, but is different entirely as to 
the nature of the work done as a result of the afferent 
impulses. 

When an impulse reaches a center, and because of an 
over-excitability of adjacent and remote centers it is 
diffused from one center to another throughout the 
entire reflex nervous centers, and when action is pro- 
duced at random without inhibition or control, we have 
what is known as an inco-ordinated reflex action. 

We see manifested such a phenomenon in tonic and 
clonic contractions, in convulsions, in spasms, and 
different forms of fits. An understanding of the inco- 
ordinate reflex action furnishes the solution of the 
philosophy of the phenomena witnessed in many such 
cases as enumerated above, and we can conceive of no 
other solution of the cause of such phenomena than that 
of diffusion of nerve impulse from one reflex center to 
another, producing inco-ordinate reflex action. 

The source of the afferent excitation that is most 
likely to produce inco-ordinate reflex-spasms and con- 
vulsions — is the afferent terminal fibers of the alimentary 
canal. Afferent excitation of the spinal reflex centers in 
children from the alimentary canal is more apt to cause 
an inco-ordinate reflex action, than like afferent stimuli 



The Sympathetic System. 87 

in older people; hence, children are more subject to 
spasms and convulsions from excitation of the stomach 
and bowels than are grown people. The stomach dis- 
turbance will often cause convulsions, while parasites in 
the alimentary canal will sometimes render children 
subject to fits or spasms. 

The author was, while visiting a doctor's office in 
St. Louis, asked to give an opinion as to the cause of a 
more or less chronic spasmodic condition of almost the 
whole body of a child which was about seven years of 
age. After due consideration, we gave our opinion of the 
etiology of the case as follows: 

That the child was suffering from alimentary irritation 
and excitation, which was causing an extensive inco- 
ordinated reflex action of the reflex centers of the spinal 
cord because of diffusion of the afferent impulses. The 
author advised that a microscopic examination be made 
of the bowel contents to determine if there were present 
any ovum or other evidences of abdominal parasites, and 
if the results were negative in this test that the child 
should be put on a fast for a few days to determine if 
the food was the excitant stimulus of the afferent impulses 
causing the inco-ordinate reflex phenomena. Pursuant 
to our advice, a thorough examination of the fecal matter 
was made, and ovum of lumbricoids were found to be 
abundant. 

There are some persons possessed of a pathological 
condition of the reflex centers of the cord, and such are 
prone to fits and spasms. One reason why our medicines 
are not effective against the phenomena of spasms and 
fits, is because the effects of them are only transient. 

There is a mechanism within the nervous system by 
means of which the production of reflex can be suppressed, 
or controlled, and which has been designated as inhibi- 
tion of reflex. Through the action of the will and the 
control of the mind over nerve function, certain reflexes 



88 Nervous System and Function. 

may be diminished or prohibited, but it is only within 
a certain limit of the amount of excitation that mental 
control can prohibit reflex action. 

Reflex action, primarily, is entirely independent of 
the will. There are certain centers within the cerebral 
apparatus in lower animals — and no doubt the same is 
true in man — that have a controlling influence over 
reflex action. 



REFLEX ACTION AND SPINAL LESIONS. 

There is another phase of the phenomena of reflex ac- 
tion that, to the mind of the author, is the most impor- 
tant for consideration of any connected with these 
phenomena. As stated above, the reflex cycle consists 
of an afferent and efferent impulse with a transfer of 
impulse intervening between them. In order to have the 
afferent and efferent impulse and reflex act, it is neces- 
sary to have the following nerve mechanism: 

1. The afferent nerve tract, together with the peri- 
pheral arrangement for the reception of impulse. 

2. We must have the reflex center or path in the gray 
substance of the cord which acts as a transfer station, 
transferring the afferent excitation or impulse to the 
efferent tract. 

3. We must have the efferent tract carrying the 
impulse centrifugally to the peripheral end of the motor 
efferent nerve to the tissues supplied. 

It is also necessary to have an excitant or stimulant 
to excite the afferent impulse which passes over the 
reflex cycle. The afferent nerve is prepared for the 
reception of excitation of impulse at its peripheral ending, 
the impulse being conducted throughout the entire length 
of the afferent nerve until it reaches the transfer station 
in the reflex center of the spinal cord. Then the impulse 
must travel over the entire length of the efferent nerve 



The Sympathetic System. 89 

from the transfer or reflex station in the spinal segments 
to the peripheral nerve endings. The entire motor nerve, 
from center to periphery, is thrown into a state of action. 
All the branches of this nerve partake of that same 
excitation, being affected by the same impulse. 

In the peripheral ending of the motor efferent nerve, 
the work done depends upon the nature of the tissues 
that are supplied. The same is true of all the branches 
given off from this motor efferent nerve which of necessity 
must become excited in the reflex act. The reflex impulse 
reaches the first branches from the efferent nerve first, 
and therefore the first action is produced in the tissues 
supplied by that branch. 

The primary posterior division of all spinal nerves 
ramifies the musculature of the spine of the relative seg- 
ment to its origin ; consequently all reflex impulses excit- 
ing a motor response, will influence and affect the muscu- 
lature of the spine. For further consideration of this 
point, we refer the reader to the chapter upon the Cause 
of Spinal Lesions. 



PART TWO. 

INTERFERENCE WITH NERVE FUNCTION. 

CHAPTER I. 

INTERFERENCE WITH NERVE FUNCTION. 

SINCE disease is essentially the phenomenon of 
deranged function, and since, during life, nerves 
function normally when ' they are not interfered 
with in any way, the study of the subject of interference 
with nerve function becomes at once one of the most 
important studies pertaining to etiological agencies. 

Nerve function is important from two considerations: 
First, normal auto-protection depends upon normal vital 
activity, which is the result of nerve impulse; therefore, 
nerve interference becomes a predisposing cause of 
infectious and contagious disease. 

Interference with nerve impulse is the cause of 
deranged function, and therefore becomes the cause of 
the continuation of disease; or, secondarily, the cause 
of the continuation of all chronic diseases. 

A thorough understanding of the manner in which 
nerves may be interfered with, is most important from 
a prophylactic standpoint,. Normal nerve supply to 
normal tissues will impart or generate therein normal 
function or health, while interference with nerve supply 
will cause deranged function, or disease. The principal 
causes of interference with nerve function may be 
enumerated under the following: 
I. Malnutrition. 
II. Nerve stimulants. 

III. Nerve depressants. 

IV. Mental impressions. 
V. Structural lesions. 

91 



92 Interference With Nerve Function. 

VI. Traumatic alterations. 
VII. Mechanical interference. 

In the above enumerations we have embraced the 
principal agencies that will increase or decrease, or in 
any way alter the normal nerve impulse and consequently 
derange the function in the zones supplied. 

I. Malnutrition. — The nutrition of nerves is nec- 
essary to their excitability and conductive power. It is 
proved by physiological experiments, that, by diminish- 
ing the arterial supply to a nerve, almost immediate 
effects are produced diminishing the nerve's action. If 
an artery supplying the nourishment to any nerve or set 
of nerves is tied, the excitability of the nerve or nerves, 
so deprived of nourishment, will be lost. If the ligature 
is removed from the artery, and if the circulation and 
nourishment to the nerve is renewed, we have a restora- 
tion of their excitability and conducting power. This 
same physiological fact can be demonstrated by pres- 
sure upon nerves. If the pressure occludes the arterial 
supply to any nerve or nerves, their excitability and 
power of transmitting impulse will be diminished or 
entirely abolished from partial or complete occlusion of 
the nutrient supply. 

If from any cause the brain becomes anaemic, the 
function of mental activity is abolished. If pressure of 
sufficient force is made upon the abdominal artery of a 
rabbit, the hind extremities of the animal will be com- 
pletely paralyzed during continuation of the occlusion. 

In the study of malnutrition of nerves, it is well to 
remember that nerves receive their nourishment through 
their cellular portion at the point of the origin of the 
nerve fiber. From this fact we must appreciate that it 
is interference with the nutrition of the central nervous 
system that has the most potent effect upon the function 
of nerves. 

Since all nerves originate within the brain and spinal 



Interference With Nerve Function. 93 

cord, except those nerve fibers originating from the sym- 
pathetic ganglia which receive their impulses from the 
cerebro-spinal nerves, it is therefore an interference with 
the circulation and nutrition within the brain and spinal 
cord, which is responsible for the disturbance that comes 
from cutting off the nutrition. 

Any spinal lesion which will interfere with the inter- 
vertebral foramina, may cause interference with the nutri- 
tion of the segment of the cord, giving off the nerves 
which pass from it. This is due to the fact that we have 
contained in the sheath of the spinal nerves, the blood 
vessels and lymphatics, which convey the nutrition to 
the spinal cord. 

The only rational way to remove the cause of inter- 
ference with the nourishment of the spinal cord, is to 
relieve the interference with the neural sheath contain- 
ing its nutrient supply and drainage. In this connection 
it might be well to consider another phase, namely, that 
of fasting and starvation. 

When man, or any other warm-blooded animal, is 
deprived of all food, nature will decompose and utilize 
the kinetic and potential energy stored in its own tissues, 
and in this way will generate bodily heat and energy to 
perform mechanical labor. The waste products of muscu- 
lar tissues during exercise will greatly decrease the amount 
of matter within the body, until death from starvation 
occurs. The cutting off of nourishment from a patient 
will reduce the bodily weight in proportion to the exces- 
sive amount upon the body of the patient, and also in 
proportion to the amount of physical exercise that is 
taken. 

The writer had one patient under his observation 
who made a phenomenal fast which stands as a world's 
record, in which the loss of weight was very small con- 
sidering the length of the fast. The patient was Dr. C. B. 
Williams, of Santa Cruz, Cal., who underwent a fast of 



94 Interference With Nerve Function. 

seventy days, and during that time ate thirteen oranges 
and fifty cents' worth of fruit. The actual loss in weight 
during the seventy days was only twenty-nine pounds. 

There is another consideration to which we wish to 
call your attention in this connection, and that is, that 
during a fast there is not that loss of strength which we 
would expect; in fact, it is claimed that the deterioration 
in strength during a short fast is not only nil, but there 
is an actual increase in endurance, if not in strength. 
This is proved by tests made at different times. 

The writer, to test this matter, went seven days with- 
out food, and took no nourishment of any nature what- 
ever, and no liquid save drinking water; walked from 
four to eight miles each day; took a Turkish bath and 
sweat, and an enema each forenoon during the entire 
fast. As a result of the absence of food, we felt no weak- 
ness, and were troubled very little with the sensation of 
hunger, but did not wholly lose an appetite. The prin- 
cipal difference noticed was that there was an absence of 
muscle tire after continued exertion, and no brain fag 
following lectures or mental work for hours at a time. 

During the week the writer was delivering from two 
and a half to three hours' lectures each day, and could 
lecture for two hours without feeling exhausted or tired 
in the least; in fact, felt like going on instead of stopping. 
After walking two or three miles, was indifferent as to 
sitting down and resting, while, before this, when eating 
regularly, a walk of one mile would cause a sense of 
fatigue and a desire to rest. The loss of weight, owing to 
the bathing and excessive exercise, was heavy, being 
twenty pounds in seven days. 

After this experience we were prepared to believe and 
to appreciate the records made in New York by Prof. 
Gilman Low. World's records in strength and endurance 
have been accomplished after a fast of a week's time. 
Feats of strength have been performed by people after 



Interference With Nerve Function. 95 

a fast of from one to several weeks, that could not be 
accomplished by the same person while upon full rations. 
We copy from the work of Irving J. Eales, Belleville, 111., 
a record of tests in his valuable book, entitled Health- 
ology: 

"Eight athletes were entered on the list on Saturday 
night at the beginning of the fast, and the same eight 
athletes presented themselves at the final contests of 
endurance on the evening of the seventh day of the fast. 
The records made by them are now world renowned. 
Mr. Joseph H. Woltering, of New York City, was awarded 
the first prize in races. He won the fifty yard dash in 
six and two-fifths seconds; the 220 yard run in twenty- 
seven and four-fifths seconds, and the mile run in six 
minutes, fourteen and two-fifths seconds. Mr. Gilman 
Low, of New York City, the well-known artist, health 
director and athlete, won first prize in strength contests. 
Mr. Low lifted 900 pounds in a straight hand grip lift, 
and the 56-pound weight was thrown thirteen feet, six 
inches. Mr. Low, to prove that his strength had not 
deteriorated a particle, lifted, on the sixth day, with hands 
alone, 500 pounds twenty times in fifteen seconds, and 
900 pounds twice in twenty seconds. With back lift, 
one ton, twelve times in twenty seconds. After the 
tests, on Saturday night, he lifted one ton twenty-two 
times in nineteen seconds, before a group of doctors, in 
order to demonstrate to them what he knew to be true 
in regard to fasting. Remember, these are now world's 
records in strength and endurance, and were made after 
seven days without food. Mr. Low broke his fast at 
Madison Square Garden after the other athletes broke 
their fast, and at the end of eight days, before 16,000 
people, established nine world records in strength and 
endurance, which have since remained world records, no 
one having been able to lower them, and these were made 
in competition with other men who had been eating 



96 Interference With Nerve Function. 

regularly, and he was going out of his class to do it. These 
nine world records are as follows, viz. : 

1. Raising 950 pounds three times in four seconds. 

2. Raising 500 pounds twenty times in fifteen seconds. 

3. Throwing 56-pound weight thirteen feet, six inches 

(for height). 

4. Leg lifting — raising with legs alone, 1,000 pounds 

fifty times in twenty-five seconds. 

5. Leg lifting — raising with legs alone, 1,500 pounds 

thirty-five times in thirty-five seconds. 

6. Raising with legs alone, 1,800 pounds eighteen 

times in eighteen seconds. 

7. Back lifting — bringing all the muscles of the back 

into action — raising 2,500 pounds five times in 
ten seconds. 

8. Raising 2,200 pounds twelve times in twelve 

seconds. 

9. Raising 2,000 pounds twenty-nine times in twenty 

seconds. 

Mr. Low has other world records, after fasting, made 
at other times, and he established the phenomenal 
record of lifting one million, six thousand pounds, in 
thirty-five minutes and thirty-four seconds. Immediately 
following this lift, he raised one ton forty-four times in 
four minutes. The lift was accomplished by lifting 
1,000 pounds 1,006 times in the time specified, the only 
man living in the history of the world who ever accom- 
plished such a feat. And this feat was accomplished after 
two months of training on what would be termed a starva- 
tion diet. The diet was as follows (I quote from a letter 
from Mr. Low to the author, dated July 2, 1907) : 

"My diet during my training for the million pound 
lift, was as follows: The first five weeks, one meal daily, 
consisting of three eggs soft-boiled or uncooked — more 
times uncooked; fruit, as oranges, grapes, apples or 
bananas; cereal and nuts, and one glass of milk after 



Interference With Nerve Function. 97 

each meal. Plenty of cool, distilled water during the day. 
As an experiment, I ate meat twice during the first five 
weeks, and I found I could have done just as well without 
it. The last three weeks I lived on four meals weekly, 
consisting of the same diet as the five weeks previous. 
At ten o'clock on the morning of the day that I made the 
lift, I increased the eggs to six, also somewhat increased 
the bread; otherwise the meal consisted of the same 
allowance. Nothing was eaten again until after the lift 
was made, which was accomplished at nine o'clock in the 
evening, making a lapse of eleven hours between the last 
meal and the lift. That which followed is already history. 
.It might be well to note that I lost during the thirty-five 
minutes and thirty-four seconds, iive and three-quarter 
pounds; fifteen minutes later I lifted one ton forty-four 
times in four minutes." 

Mr. Low had previously attempted this feat and 
utterly failed, reaching only a little over the half million 
mark in twenty-five minutes. Then he ended in sore 
distress and dizziness. He had been eating two meals 
daily. Mr. Low says freedom of lung power is very 
important in lifting, for as one ceases to breathe well, 
the muscular power fails. He believes in cutting down 
the food and practicing deep breathing. He is a model 
of physical perfection as shown by his measurements, 
obtained and perfected entirely through his methods, viz. : 

Neck 17 in. Hips ...39 in. 

Chest, contracted. 37 in. Thigh 263^ in. 

Chest, normal. . . .45 in. Knee 143^ in. 

Chest, expanded. . 52 in. Calf 163/2 in. 

Waist 34 in. Ankle 9 34 in. 

Biceps 16^ in. Height 5 ft. 9 % in. 

Forearm 13 in. Weight, stripped. . 187 lbs. 

Dr. Eales says that: 

''In a letter to Prof. Gilman Low, shortly after my 
fast in July, 1907, I called his attention to my strength 



98 Interference With Nerve Function. 

tests, and to the fact that there was no impairment of 
strength after my long fast, asking him what his experi- 
ence was in regard to his strength after a fast. I also 
informed him that a number of the doctors here had 
stated that it was impossible for one to go thirty-one 
days without food; that in one week a person would be 
so weak he could scarcely walk, and a few more days 
would endanger life. In answer to my letter, Prof. Low, 
among other things, writes as follows, in a letter dated 
July 29, 1907: 

" 'At the end of my fifteen-day fast some years ago in 
Boston, I could have thrashed my weight in wild cats. 
If the doctors you refer to in your letter, think a man will 
be so weak in a week's time he cannot walk, I will fast 
fifteen days and if any two of them can handle me (in 
any way suitable to them) I will give them each $100.00. 
In other words, immediately following a fifteen-day com- 
plete fast on my part, I will be willing to place myself in 
a room of their own choosing, dressed the same as they 
and empty-handed absolutely. Then send in any two 
of these doctors to drive me out (or perhaps they think 
I would be so weak they would have to carry me out) 
and if they succeed in driving me out, or ridding the 
room, they are privileged to kick, scratch or bite, then 
they can each have $100.00. If I put them out, which 
would surely be the case, no matter how big they are, 
then they are to give me $100.00 between them. Is this 
fair, Doctor? It would then be laughter and applause 
on my part. Very truly yours, Gilman Low." 

Some of the causes of interference with the nutrition 
of nerves may be enumerated under the following head- 
ings, namely: 

1. Overfeeding. 

2. Underfeeding. 

3. Poor digestion. 

4. Poisonous food. 



Interference With Nerve Function. 99 

5. Poor assimilation. 

6. Occlusion of circulation. 

7. Impingement of gray rami. 

Any of the above causes will sooner or later cause an 
alteration of the amount or quality of the nutrient supply, 
and any alteration of the character of the nutrient supply 
will be more baneful in effects than a mere deficiency of 
nutrition, especially if the nutrition in any way become 
toxic in character either from the nature of the food or 
from changes taking place causing the development of 
toxic elements. 



CHAPTER II. 
NERVE STIMULI. 

ANY agency that acts as an excitant or stimulus to a 
nerve, will alter and derange the functions thereof, 
and nerve function may be altered in two ways : 

1. Nerve stimuli will increase the excitability and 
transmitting power of nerves, but the effect may be 
transient. 

2. Nerve stimulation, after being excessive, or em- 
ployed for a sufficient length of time, will produce the 
opposite effect, and thus decrease the nerve's excitability 
and power of conductivity. 

By nerve stimulant we mean any agency or material 
or any condition that will excite a nerve. The action o* 
a nerve stimulus is similar in effect to the action of a 
goad when applied to a tired horse. Nerve stimuli excite 
an expenditure of the reserve nerve energy, but does not 
add to the amount of nerve energy in any way. 

The effect of a nerve stimulus depends upon the 
property possessed by the nerve enabling it to be thrown 
into a state of excitability. We enumerate below some 
of the more common nerve stimuli under the following 
heads : 

I. Toxins. 
II. Medicine. 

III. Chemicals. 

IV. Electricity. 

V. Mechanical action. 
VI. Physiological action. 
VII. Extremes of temperature. 
Any of the above will act as nerve stimuli, but the 
action of each depends upon the amount and condition 

of their application. Some of the nerve stimuli may also 

100 



Nerve Stimuli 101 

act as nerve depressants because of the depressing 
influence upon the functional activity of nerves, as the 
result of an excessive or long continued excitation. 

I. Toxins. — Under the head of toxins we refer to 
those which are produced by the action and development 
of bacteria, and more especially to those toxins produced 
by pathogenic bacteria within the human body. 

The action of toxins produced by germs has a decided 
effect upon the thermo-genetic action of the nervous 
system, and therefore toxins become the cause of the eleva- 
tion of temperature in the majority of febrile conditions. 
There is no other toxic element with which we are ac- 
quainted that has such a decided action upon the heat 
production, as do those of pathogenic bacterial origin. 

Germs of themselves are harmless in the human body, 
that is from the standpoint of their existence and pres- 
ence, but as a result of their incubation we have toxins 
produced, and it is the production of their development 
that is responsible for the exciting or stimulating action 
upon the thermic nervous mechanism. In all cases of 
toxic conditions and resultant fevers accruing frm boy- 
products of pathogenic infection, the results are mani- 
fested only after the incubation period. 

TOXINS FROM OTHER SOURCES. 

A S the result of the failure of the action of the skin, as in 
■* *- hysteria or in sunstroke, we have auto-intoxication. 
If the skin is varnished, the retention of the toxic and 
effete matter that is no longer eliminated will produce a 
very rapid increase of heat production, and will soon 
produce fatal results. 

We may also have an auto-intoxication from fermenta- 
tion in the alimentary tract. This will likewise excite 
heat production. In local areas we may have ulcers, 
boils, carbuncles, and other pathological processes in 



102 Interference with Nerve Function. 

which we have pyogenic bacteria causing a local fever, 
and other symptoms of inflammation. If there is an 
absorption into the general circulation taking place from 
a local zone of bacterial action, we will then have general 
or constitutional symptoms, as the result of the absorp- 
tion of toxins. 

None of the nerve stimuli produce as powerful an 
excitation of the thermogenetic centers of the nervous 
system, as do the toxins of pathogenic bacteria; hence 
fever is readily produced in all cases as a result of the 
action of these toxins upon the thermogenetic centers of 
the nervous system. 

II. Medicines. — Medicines are the most frequently 
used of the different nerve stimuli. This is due to the 
fact that medicine is relied upon almost wholly by the 
largest school in the practice of medicine. Medicine will 
excite nerves, and cause an increased action, and almost 
any part of the nervous system may be affected. 

Practically all the functions of the nerves may be 
stimulated by the use of different medicines. For example, 
we may affect the vasomotor action of the nervous sys- 
tem generally, and in this way we may increase the 
action of the nerve supply upon the heart, the kidneys, 
the stomach, or almost any viscera or organ of the body. 

Now the exciting action of medicine acts in two ways: 

1. They may increase the excitability and trans- 
mitting power of the conducting fibers of the nervous 
system; or, 

2. They may ultimately, because of excessive doses 
and excessive excitation, have a depressing effect upon 
the functional activity of the nervous system. 

We must remember that when we, with medicine, 
excite or stimulate the action of the nerve supply beyond 
normal to any zone of the body, we are doing so by excita- 
tion. Therefore, the effects we get from medication are 



Nerve Stimuli. 103 

temporary, lasting only as long as the excitation from the 
medicine, and for this reason chronic diseases cannot be 
cured by medication, but they may be for the time relieved 
by the temporary effects thereof. 

In acute cases, medicine may accomplish something 
by virtue of its temporary effects, because nature may be 
able to make matters right by the time the transient 
effects of the medicine have ceased. 

III. Chemical Stimuli. — Chemicals will excite nerves 
when of sufficient strength to cause alterations in the 
constituents of the latter within a limited degree of 
rapidity, and, like thermic stimuli, and practically all 
other stimuli, they first increase the irritability of the 
nerves, and then diminish their excitability to the point 
of abolition. 

Chemical stimuli as a rule have less effect upon either 
sensory or afferent nerves than do thermic, but more 
especially is the effect upon nerves manifest from chemical 
stimuli, than from thermic stimuli. 

Under the head of chemical stimuli we embrace both 
acids and alkalies, both of which have a positive action 
upon the nervous system, and produce an excitation of 
the nerves when applied. The result of the application 
of acids or alkalies to a nerve depends upon its strength. 
In physiological experiments we use applications of acids 
and alkalies to produce stimulation. 

The cut ends of nerves may be stimulated by the 
application of a weak solution of acids or alkalies. If a 
nerve is cut, we note the cessation of the function which 
is produced by it. After the application of the nerve 
stimuli to the cut end, we have a reappearance of the 
functional phenomena, which is proof of the stimulating 
effect of the stimulus, and also gives us an insight into 
the action or function of the nerve upon which we are 
experimenting. 

Acid tonics are used to stimulate the stomach action 



104 Interference with Nerve Function. 

sometimes; acid and alkalies are used as medicine 
because of their exciting or stimulating effect upon the 
sensory nerve and the consequent reflex action and motor 
activity. 

IV. Electricity. — Electricity is the most positive, 
most powerful, and one of the most specific excitants or 
stimuli that we can apply to an individual brain center 
or to an individual nerve, where it may be prepared for 
the reception of stimulation. 

The electric current exerts the strongest effect as a 
stimulus at the time of making and breaking the current. 
The irritating effect of the electric current is also enhanced 
at the time of a rapid increase or decrease of the current. 
If the electric current is gradually increased or decreased, 
it will produce less of an irritating effect. The more 
sudden the beginning or an increase of an electric current, 
the more marked is the resulting stimulation. 

Nerve stimulation by means of electricity is transient 
in effect. After the cessation of the action of the stimulus, 
we have a depressed condition of the excitability and 
transmitting power of the nerves. If the electric stimula- 
tion is maintained for a considerable time, no doubt a 
good deal of work may be done by glands that have been 
partially inactive. As a result of overwork because of 
excitation, some relief from the conditions that exist 
may be experienced. 

This temporary relief may cause a patient to feel that 
he has been benefited by an electric treatment, but no 
doubt in the great majority of cases the beneficial effect 
is but transient. It is for the above reasons that electric 
stimulation does not effect more cures; however, electricity 
may do some good in certain cases if properly applied, 
for the reason that it may affect the metabolic processes 
and increase growth and development in the early stage 
of animal life. 



Nerve Stimuli. 105 

V. Mechanical Action. — Mechanical stimuli will 
affect nerve action when they induce a change in the 
nerve particles within a certain degree of rapidity. 

The subject of mechanical interference is one of vastly 
more importance than it is at first considered. It is a 
well recognized fact that the following agencies will act 
as mechanical stimuli when the application is of sufficient 
degree of intensity: 

1. Blow. 

2. Section. 

3. Traction. 

4. Pressure. 

5. Puncture. 

6. Crushing. 

7. Percussion. 

The most frequent point of mechanical interference 
with the normal nerve function is where the nerves make 
their exit from the neural canal through the foramina 
formed by notches in the adjacent pedicles of vertebrae. 
This is due to the contractibility of the musculature of 
the spine. Spinal tissues contract the same as tissues of 
any kind in any part of the body. This subject will be 
considered more fully under the heading of Spinal Lesions. 

We have a much more frequent agency of mechanical 
irritation used in practice affecting nerves than any of 
the above enumeration, as follows: 

Mechanical excitation and stimulation of the roots of 
the spinal nerves may be excited by percussion over cer- 
tain spinal centers. If we are thoroughly acquainted 
with the spinal centers and their action upon the organs 
which they supply, we are enabled to cause a vaso- 
constriction or vasodilation of the vascular system and 
of the tissues of the viscera of the thoracic, abdominal, 
and pelvic cavities. In this way mechanical stimulation 
induced by percussion may be used as a very potent 



106 Interference with Nerve Function. 

remedial agency in the treatment of functional disorders 
of the viscera. 

VI. Physiological Action. — The nature of the phy- 
siological nerve stimulus is not understood, but we know 
something of the phenomena produced. 

The physiological nerve impulses emanate or originate 
in the central nervous system in the brain or spinal cord. 
They pass at frequent intervals over the efferent nerve 
routes to their peripheral endings, and in this way the 
automatic performance of nerve function is maintained. 
The physiological impulses are in life forces continually at 
work. 

The afferent stimulation from the normal physio- 
logical excitation, will also fall in this division, and we 
have examples of this in the circulation of the blood and 
in the phenomena of digestion and assimilation. The 
physiological impulses are generated and pass at all 
times during life from the nerve centers, and it is claimed 
by physiologists that we have from seven to ten waves 
of impulses per second generated within and emanating 
from the centers of the nervous system. 

That we may have the normal transmission of the 
physiological impulses from the nerve centers, there must 
be a normal condition of the nerves over which the impulse 
travels, and freedom from any mechanical interference. 

VII. Extremes of Temperature. — The application 
of either extreme cold or heat will excite nerve action by 
stimulation of the afferent nerve endings in proportion 
to the extreme of the temperature and the duration of 
the application. Cold applied to the surface of the body 
for a short space of time will excite the afferent nerve 
endings and produce a vasodilator effect upon the 
peripheral vascular system and a reaction against the 
cold. 

The effect of a continued application is quite different 
from that of a brief application. The secondary effect 



Nerve Stimuli. 107 

of the application of cold is to depress the sensibility and 
excitability of the afferent nerve endings. The ultimate 
effect of the cold application is paralysis. The ice pack 
applied to the head of a patient day after day will pro- 
duce fatal results in practically every case. Too long an 
application of the ice to the head undoubtedly is a great 
mistake, and one that is too often made. The centers 
of the wonderful mechanism of the nervous system are 
paralyzed by the continued application of cold; conse- 
quently the function throughout the body is suspended. 
Heat has ultimately the same effect as cold, when the 
application is extreme for a sufficient length of time. The 
primary effect of heat is vasodilation, but the continued 
application causes vasoconstriction. Heat acts as a 
nerve stimulant according to the extreme of the appli- 
cation. The lighter applications of heat will produce a 
longer period of stimulation, while the more severe 
applications will produce a more intense excitation, but 
the period of duration is less. 



CHAPTER III. 
NERVE DEPRESSANTS. 

WE enumerate a list of the more common agents 
that may interfere with nerve conductivity, as 
follows : 

1. Narcotics. 

2. Anaesthesia. 

3. Compression. 

4. Lack of oxygen. 

5. Cold application. 

6. Lack of nutrition. 

7. Galvanism (polarizing current). 

This enumeration embraces agencies that have a 
depressing effect upon the conductivity of nerves, and 
from this standpoint we will consider them briefly: 

1. Narcosis. — Narcotics benumb or deaden the excit- 
ability and transmitting power of the afferent or sensory 
nerves. Narcosis may be produced by the use of drugs, 
and this is done in the practice of medicine for the relief 
of pain in many cases. Narcotics in small doses or in 
weakened solutions, primarily act as nerve stimuli, but 
the secondary effect will lessen the excitability and 
sensibility of nerves. Full doses of narcotics quickly 
benumb, deaden and destroy, and if the effects become 
general, we may have unconsciousness, sleep or coma. 

Narcotics depress the conductivity of nerves and 
lessen their capability of being stimulated to action, by 
decreasing their excitability. When a nerve loses its 
excitability as the result of a narcotic, ordinary afferent 
stimulation fails to excite an impulse, and should an 
impulse be excited, it would not be transmitted owing 
to the lowered condition of the nerve's power of conduc- 
tivity. 

Different drugs are used as narcotics. Among those 

108 



Nerve Depressants. 109 

most commonly used, we might mention alcohol, opium, 
tobacco, chloral, hyoscyamus, cannabis indica, and a 
number of coal tar derivatives. The latter are now 
being manufactured and used quite extensively by 
medical practitioners. 

2. Anesthesia. — Anaesthetics produce a condition 
of partial or total insensibility of the sense of touch or 
feeling. Local anaesthesia affects a limited or restricted 
area and is used in local minor surgical operations, while 
a general anaesthesia affects the sensibility of the entire 
nervous system and is used in major surgical operations. 

Anaesthetics produce their effects by paralysis of the 
sensory nerves, thereby decreasing their excitability and 
power of transmission or conduction of nerve impulse. 
Chloroform and ether have long been used as the principal 
anaesthetics by surgeons. 

Anaesthesia is a blessing to the patient who would 
undergo a surgical operation, not only because it destroys 
the sensibility of the nerves to pain, but further, because 
it prevents the reflex contractions of the spine that 
would be the natural consequence of the irritation of the 
surgeon's knife and disinfectants and other irritative 
processes of the operation. 

An afferent nerve which is robbed of its excitability 
and transmitting power, will not transmit an impulse 
to the reflex center of that nerve, and consequently 
does not excite the motor nerve and the spinal contrac- 
tion which would occur, were the nerves in a normal 
condition as to excitability and transmitting power. 

3. Compression. — Compression depresses the conduc- 
tivity of nerves when the compression is of sufficient 
extent to interfere with the cellular structure thereof. 
Impingement will alter the conductivity of both afferent 
and efferent nerves. The effects vary according to the 
amount of pressure, and the consequent disturbance of 
the cellular structures of the nerves. 



110 Interference with Nerve Function. 

Slight impingement will produce an inflammatory, 
and consequently a hyperaesthetic condition of the sen- 
sory nerves, which will increase the excitability and 
power of transmission or conductivity. Therefore slight 
impingement would come under the head of nerve 
excitants or stimulants. 

The primary and secondary effects of slight impinge- 
ment vary. If a slight impingement is long continued, 
the secondary effect may induce the opposite condition 
or result; that is, the secondary effect of slight impinge- 
ment may depress the conductivity and power of trans- 
mission of nerve impulse. Increased pressure upon 
nerves excites them more intensely, but the state of 
excitement is more transient, and the sooner and more 
complete is the nerve action depressed. 

Every impingement or pressure upon nerves will 
cause intense pain, and in extreme cases will soon pro- 
duce the secondary effect, which is that of complete 
paralysis. Mechanical interference with nerves, then, 
may produce either of two effects: Inflammatory, 
excitable or increased action, or a depressed, benumbed 
and paralyzed condition of the nervous system — either 
condition will alter the function thereof. 

4. Lack of Oxygen. — In a case of suffocation by gas, 
death is due to the cutting off or deprivation of the nec- 
essary amount of oxygen. Patients in advanced stages 
of typhus and other wasting diseases, suffer from the lack 
of aeration of the lungs, but the distress that is produced 
thereby, may be quickly overcome by the use of free 
oxygen. Thus we see that oxygen is necessary to the 
sustenance of vitality and action of the nervous system. 

In the physiological laboratories of nature, oxygen is 
a very necessary element in the process of metabolism. 
It combines with the necessary elements of nutrition, 
and aids in the sustenance and the processes of cellular 
action. Oxygen, while combining with the necessary 






Nerve Depressants. Ill 

elements, liberates or sets free the by-products resulting 
from muscular action, or tissue activity, and also com- 
bines with waste elements associated with the food sub- 
stances. Cutting off the oxygen supply soon produces a 
paralytic effect, or complete paralysis. 

We can live for weeks without food, but suffocation 
will soon occur without oxygen. An interesting example 
of the exhilarating effects of oxygen and water is illus- 
trated by Dr. H. S. Tanner during his fast in the city of 
New York. During the first fourteen days of the fast 
Dr. Tanner took no nourishment and drank -no water, 
and as a result he lost strength to a considerable extent. 
On the fourteenth day he visited the park and drank 
freely of soft water, and when he returned to the hotel 
he felt invigorated and strengthened, and went upstairs 
two steps at a time. 

On the seventeenth day, after he had been using water 
for three consecutive days, he remarked to a medical 
student, that water and oxygen were two great nerve 
tonics. The medical student responded: "Oxygen and 
water may do for you all right, but for my part, I prefer 
beefsteak as a nerve tonic." Dr. Tanner suggested that 
they try a little feat of endurance to see which was more 
effective as a nerve tonic — meat, or oxygen and water. 

They ran a race around the corridor of the hotel. 
After eighteen rounds Mr. Beefsteak fell out to one side, 
exhausted, gasping for breath, his heart struggling to 
carry the burden engendered by the violent exercise, but 
Dr. Tanner went skipping on. Manifestly this was a 
victory for oxygen. 

5. Cold Applications. — Cold applied to any part of 
the body acts primarily as an excitant or stimulant by 
its action upon the sensory nerve endings in the zone 
affected. Cold excites a decided reflex action, which acts 
both upon the muscular tissues and the vascular system. 



112 Interference with Nerve Function. 

Blood rushes at once to the area that is in contact with 
the cold application. 

The stimulating or exciting influence of a cold appli- 
cation is short in duration. Soon there is induced a 
benumbed condition, and a long continuance of an ex- 
tremely cold application will produce complete paralysis. 

Cold is often used as an anodyne for the relief of pain, 
because it destroys the excitability and sensibility of the 
sensory or afferent nerves, but it is not good practice to 
deaden a live nerve, because it acts correctly in giving 
information of lesions causing pain. 

Psychotherapy is frequently used in neuralgic affec- 
tions of the nervous system. Cold applications are used 
to allay inflammatory conditions in which the processes 
of inflammation are active. 

Cold is also used to abstract heat in feverish conditions 
from almost any part of the body. Cold or ice packs to 
the head are frequently used to allay an inflammatory 
condition. We believe, however, that much harm can be 
done by the depressing and paralyzing effect of cold 
compresses to the head, if they are continued without 
interruption for too great a length of time. 

No doubt the continued and injudicious use of cold 
packs to the head are responsible for fatal results many 
times in the hands of physicians who do not understand 
the proper use of this valuable remedial agency. The 
paralytic effect may be avoided by alternating cold appli- 
cation with applications of heat. If a cold application 
is applied for four minutes, and a warm application is 
applied for one minute, and repeated in this way, we may 
get the depressing and sedative effect of the cold without 
producing the complete paralysis which we will produce 
by the continued use of the cold application. 

6. Lack of Nutrition. — Lack of nutrition deprives 
nerves of their excitability and power of action. As 



Nerve Depressants. 113 

brought out above, a temporary fast does not interfere 
with the nerve action, because of the fact that nerves 
are nourished at the expense of other tissues of the body. 

The manner in which we learn that nutrition cut off 
from nerves, depresses their action, is by tying an artery 
and noting that the irritability is destroyed. Then, by 
untying the blood vessel and re-establishing the nutrient 
supply, we note that the excitability and function of the 
nerve is restored. The same is demonstrated by pressure 
upon an artery. 

When, by occlusion, the artery cuts off the nutrient 
supply, nerves cease to function. When the pressure is 
removed and the nutrient supply re-established, the 
nerve supply will regain its function. 

7. Galvanism (Polarizing Current). — Electricity, 
ordinarily, is a nerve excitant or stimulant, but the 
polarizing galvanic current benumbs and paralyzes both 
afferent and efferent nerve fibers. This current com- 
pletely destroys the excitability and conducting power 
of nerves, especially when used excessively. 

While considering the subject of interference with 
nerve function, we will call attention to the phenomena 
which we see continually produced that requires some 
explanation : 

Muscle fatigue is produced by the chemical by- 
products of metabolic changes occurring in the tissues 
during exercise. Continued exercise and excessive action 
increases the production of waste material in the shape of 
certain chemical elements. 

These fatigue elements which produce muscle tire, are 
in the form of acid salts, acid potassium phosphate, 
glycerin, phosphoric acid, and carbon dioxide. The proof 
that these by-products, generated during muscular activity, 
are the cause of muscle fatigue, is because of the fact that 
when these elements are washed or thinned by a weak 



114 Interference with Nerve Function. 

sodium chloride solution, the muscle fatigue is no longer 
manifest or present. 

Sleep seems to be produced as the result of certain 
by-products of muscular activity, and ordinarily the 
more exercise taken, the sounder will be the phenomenon 
of sleep. In childhood, while the eliminative processes are 
perfect, and throwing off all the by-products of muscular 
activity save those which conduce to sleep, there is 
perfect rest during the sleeping hours. 

In after life the sedative effect of muscular activity 
seems to be nullified to a certain extent by the failure 
of the elimination of certain toxic elements on the part 
of the kidneys or skin. These retained toxins in such 
cases act as excitants, and counteract the somnifacient 
influences of the normal producers of sleep. 

We find that when the eliminating organs are stimu- 
lated to normal action by re-establishing normal nerve 
supply or elimination, that our patient will again sleep 
as well as in youth. 

Deranged function of the mental phenomena may be 
due to the toxic elements influencing the cellular activity 
of the centers of intelligence in the brain, and by derange- 
ment of the nutrition, and consequently of the metabolic 
processes, causing an alteration of the cellular tissues of 
the brain. 

Any failure of the normal supply of nutrient elements 
to the brain substance, or any failure of a proper, free 
drainage, and any organic lesions of even the slightest 
degree, will materially interfere with the normal func- 
tioning of the brain; hence mental aberrations. 

A proper understanding of the etiological factors of 
insanity would lead to the proper treatment, and our 
asylums would be quite unnecessary with their present 
extensive apartments. Many of their inmates could be 
sent home entirely relieved of all occlusion of nutrient 



Nerve Depressants. 115 

vessels, physical interference with the nerve supply to 
the seat of intelligence — the brain — thus normal function 
would be restored to the great majority of the inmates of 
our state institutions, which are established for the care 
of those mentally afflicted. 



CHAPTER IV. 

NERVE DEPRESSANTS— (Continued). 
MENTAL IMPRESSIONS. 

IT is a well-known fact that suggestion and mental 
impressions will affect the brain and nervous system. 
If you hear bad news or sad news, you are depressed ; 
if you hear good and encouraging news, you are exhila- 
rated. Suggestions that you are sick or looking bad, or 
that you cannot get well, are very detrimental to recovery ; 
while the reverse suggestions, those of optimism, are 
really conducive to the recovery of health. 

All schools of physicians practice suggestion either 
consciously or unconsciously. When the allopathic 
physician gives medicine he usually suggests, when pre- 
scribing it, the effects he expects it to have and the effects 
will follow in the line of the suggestion. Sometimes 
inadvertently he may give a counter-suggestion. Suppose 
a physician should say to his patient: "Try this medicine 
and come back at the end of the week, and if it has done 
you no good, I have another medicine I want to give you." 
Do you think that medicine is likely to act? The patient 
will most likely return for another prescription. 

I heard of a physician who gave a rheumatic patient 
a medicine for rheumatism, and remarked: "If this does 
you any good, come back and tell me about it, for I have 
had the rheumatism myself for seventeen years." 

There is so much in suggestion that there has been 
established a school of practice based upon it. For a 
long time I was inclined to the idea of condemning every 
other method of healing besides the one I was practicing, 
but I have, gotten over the idea that I know it all and the 
other fellow knows nothing more than I do. 

116 



Mental Impressions. 117 

I remember a case in Oklahoma. Dr. M. had a case 
of constipation that was very stubborn. He had tried 
cathartics, and one by one they would lose their efficiency. 
After the doctor had gone the rounds of the different 
cathartics he thought he would try suggestion. He 
suggested to his patient that he had one medicine he 
had not given her because it was such a powerful cathartic, 
and that it was so severe in its effects, that he did not 
want to give it. He left that suggestion with her for 
about three weeks, and she made up her mind to take 
that medicine if it killed her. She told him that she had 
resolved to take that medicine for the better or the 
worse. He administered some ordinary placebo pills. 
She went home, and before morning the doctor was 
called to her rescue, for there was such a drastic cathartic 
bowel action. 

We know of another case in Oklahoma that illustrates 
the influence of suggestion. A farmer living about six 
miles east of Oklahoma City, told about the time when 
he used to take some herb tea that his mother made and 
gave him for a purgative. Finally this cathartic began 
to affect him. in the wrong manner; in other words, 
began to induce a condition of constipation. 

This man tried auto-suggestion. He would imagine 
that there were peristaltic movements of the bowels. 
He would imagine the bowels were going to act, and 
actually brought on a desire to go to stool. When he 
first began he would work his auto-suggestion for prob- 
ably half an hour before he would accomplish the desired 
effects, but after his mind had practiced this suggestion 
for awhile, it would work better. When he would begin 
to think about his bowels moving, he would go, of neces- 
sity, at once. There is one thing I believe concerning 
this remedy: It is better than medicine for chronic 
constipation. 

I heard of a case in an Eastern city that illustrates the 



118 Interference With Nerve Function. 

effects of mental influence. A gentleman went to see a 
doctor, consulted him, and had a thorough examination. 
The doctor reported the examination to him next day by 
mail. When the patient read the letter containing the 
doctor's report he was perfectly surprised. The letter 
read something like this: "One lung is gone; heart is in 
bad shape, you cannot live long, the thing for you to do 
is to make ready your affairs in this world, for you have 
not long to live." The poor fellow lingered under the 
influence of that suggestion and took to his bed. When 
the doctor was called to visit him, the patient said: "Oh, 
Doctor, my heart, my heart." The doctor said, "I 
examined your heart three days ago and found nothing 
the matter with it." "But, Doctor, my lungs." "I 
examined your lungs about three days ago and found 
nothing the matter with them." "Where is that letter 
I wrote you?" the doctor asked. The patient produced 
it. "But that letter," the doctor said, "was meant for 
another man." This patient got better right away. He 
got up out of bed, went to the seashore, and recovered. 
The letter that went to the other man read something 
like this: "Nothing seriously wrong; a little rest at the 
seashore will make you all right." The poor consumptive 
went to the seashore for rest, and he got well also. We 
must admit that there is something in suggestion. 

V. Structural Lesions. — We may have structural 
lesions as a result of interference with the processes of 
metabolism, or we may have structural lesions as a result 
of injuries, traumatic wounds, etc. In either case, it 
will be impossible for nerves to function normally through 
organs which are not organically normal. It is necessary 
for the structure of the organ to be perfectly normal, 
that nerve impulse may produce normal function within 
them. Any interference with the normal impulse which 
disturbs the metabolic processes in any way, will sooner 
or later lead to a histological alteration, and then should 



Mental Impressions. 119 

the nerve be freed from interference, it is necessary for 
sufficient time to elapse for metabolic processes to remove 
this histological obstruction before nerve impulse can 
produce normal functional processes. 

VI. Traumatic Alterations. — In the case of trauma- 
tism produced by accident or by surgery, in which tissues 
have been removed, or in which nerves have been severed, 
it is impossible to ever restore normal function again. If 
a patient has lost one finger, he can never grow another. 
The crawfish that has lost his pinchers may grow others, 
but to an unfortunate child which was born without an 
extremity, we will never be able to restore a normal limb 
or part thereof. To a person who is minus some of his 
organs by reason of an operation, we will never be able 
to restore the organ, nor be able to overcome the lack of 
the internal secretion produced thereby, as in the case 
of the ovaries. 

When nerves are severed, and when their terminal 
branches are degenerated as a result thereof, we are not 
able to again restore the function that is normally 
maintained by that nerve. 

VI. Mechanical Interference. — Mechanical inter- 
ference with nerves and derangement of function by 
reason thereof, is by far the most common of all agencies 
of interference with nerve function. Mechanical inter- 
ference with nerves, however, had been almost wholly 
overlooked as an etiological factor of abnormal function 
and disease. 

Mechanical action which interferes with the histo- 
logical particles of a nerve within a certain range of 
rapidity, becomes a stimulus or an excitant or irritant of 
that nerve. When the mechanical action is sufficient to 
destroy the continuity of the conducting cellular tissues 
of the nerve — the axis cylinder — the nerve is paralyzed, 
and the nerves will undergo degeneration from the point 



120 Interference With Nerve Function. 

of the lesion or impingement peripherally, as a result of 
a permanent disturbance of the cellular arrangement of 
the nerve particles. 

A slight impingement or pressure upon a nerve 
causes the nerve to become tender, sensitive, and very 
excitable, which condition increases its action. 

If, however, the impingement is long continued, a 
secondary effect will ensue. The nerve then will fail to 
possess the excessive or normal amount of excitability 
and transmitting power. A very slight impingement, 
however, may act as an excitant or stimulant for a long 
period of time. 

Mechanical stimulation of peripheral afferent nerve 
endings is normally present in a majority of the processes 
of vital activity throughout the entire body. In the 
alimentary tract we have an example of the mechanical 
stimulation of afferent nerve endings, and reflex afferent 
responses, throughout its entire length. 

Food in the mouth is the mechanical stimulus that 
excites glandular secretion in the form of saliva. We know 
that this reflex secretion of the salivary glands is in 
response to mechanical stimulation, from the fact that 
the saliva will flow from the presence of any form of 
matter that is placed in the mouth, provided the pro- 
cesses of mastication are carried on. Saliva flows during 
the mastication of food; it will also flow while chewing 
a stick, and will even flow while chewing tobacco. 

It makes no difference what the nature of the mechani- 
cal stimulation is. We always have a response in the 
flow of saliva, which proves conclusively that purely 
mechanical stimulation will excite the action. 

In the event of deglutition, we have an example of 
reflex muscular movements in response to the stimulation 
of the bolus of food. Except the initiatory movement of 



Mental Impressions. 121 

deglutition, the entire process is that of a reflex muscular 
contraction in response to afferent excitation. 

In the stomach, we have the same phenomenon, 
namely: The presence of food exciting the peristaltic 
movements and the secretion of the digestive fluids of 
the stomach. In the intestinal action we have the same 
phenomenon repeated. The point we would especially 
call the reader's attention to in this article, is that of 
the mechanical interference with nerve action. This is 
usually produced by a narrowing of the intervertebral 
foramen which causes an impingement of the nerve 
sheath at its point of exit from the neural canal. A slight 
impingement of the nerve sheath, especially if it affects 
the nerve contained therein, will excite to overaction the 
nerve passing therein. The nerve may become very 
tender, sensitive, and excitable, and hence all afferent 
stimulation excites an impulse above the normal, and 
the consequence is an overaction of the motor nerve in 
response to the stimulation. 

The impingement may be sufficiently heavy to cause 
a pain, and this is proven by the fact that when the 
contraction of the spine, which is causing the narrowing 
of the foramina, is overcome, the pain and sensitive 
condition of the nerve is entirely relieved. 

As indicated above, if the nerve is impinged for a 
long time, there may be a loss of the sensibility, and 
consequently a lack of response to stimulation. There 
may also be an interference with the transmission of 
impulse by the nerve because of the mechanical inter- 
ference. 

If the impingement is heavy, the excitable stage is of 
less duration, and more quickly does the nerve become 
paralyzed and lose its power of action. We enumerate 



122 Interference With Nerve Function. 

some of the different ways in which mechanical stimuli 
may be applied to a nerve: 

1. Blow. 

2. Section. 

3. Traction. 

4. Puncture. 

5. Pressure. 

6. Crushing. 

7. Percussion. 



CHAPTER V. 
SPIXAL LESIONS. 

THE subject of spinal lesions and the methods of 
correction thereof, have probably received less 
attention, considering the great importance thereof, 
than any subject of like magnitude relative to pathology 
and disease. Gross or major lesions of the spine have 
forced their attention upon the medical profession gen- 
erally, but minor spinal lesions and those not visible to 
the casual observer, have been passed unnoticed except 
by those who have given special attention to the study 
and practice of the science of spinal adjustment. 

There has been some reference made to the associa- 
tion of spinal lesions with certain functional derange- 
ments, by members of the medical profession, but an 
extended study of this subject has not been made until 
the appearance of some more recent schools of practice 
upon the scene. We find that references made to this 
matter in the past are but few, and the study that has 
been made of it, very limited compared with its impor- 
tance. 

William and Daniel Griffith, physicians of England, 
published a report of 148 cases, in which they associated 
the ailments of then patients with manifest spinal lesions, 
or spinal tenderness. By them the phenomena of disease 
were studied relative to spinal nerve tenderness in cer- 
tain regions or spinal segments. They decided that 
tenderness of a spinal segment was either the result of 
a visceral disease, or that it was the cause of the disease. 
They queried as follows: 

We should like to learn why pressure on a particular 
vertebra increases or excites the disease about which we 
are consulted; why it at one time excites headache, or 

123 



124 Interference With Nerve Function. 

croup, or sickness of the stomach; why in some of these 
instances any of these complaints may be called up at 
will by pressure upon a corresponding point of the spinal 
column. The following report of these cases summarizes 
briefly the results of their investigations : In an examina- 
tion of twenty-eight cases, in which there was discovered 
cervical tenderness, it was found that the patients were 
suffering with headache, nausea or vomiting, facial 
neuralgia, fits of insensibility, and affections of the 
upper extremity. Two cases only had pain in the stomach, 
while only five of the twenty-eight suffered with nausea 
and vomiting. 

In forty-six cases that were found to have cervical 
and dorsal tenderness, the following derangements were 
noted in connection with those enumerated in the above 
cases, which were associated with cervical tenderness: 
Pyrosis, palpitation of the heart, and general oppression. 

Thirty-four of these cases suffered with pain in the 
stomach, and ten cases suffered with nausea or vomiting. 

They report twenty-three cases of tenderness in the 
dorsal region, with the following symptoms: Pain in the 
stomach and sides, cough, syncope, hiccough, and eructa- 
tions of gas. In one case only, nausea and vomiting. In 
almost all of these cases there was pain in the stomach. 

They report also fifteen cases in which there was 
dorsal and lumbar tenderness, which they elicited by 
palpation. The symptoms attending spinal lesions in 
these two regions, according to their report, were pain 
in the abdomen, loins, hips, lower extremities, dysury, 
ischury; in addition to the symptoms attending the 
twenty-three cases of dorsal tenderness. In only one 
case was there nausea. 

Thirteen cases which were found to have tenderness 
in the lumbar region, are reported with the following 
symptoms: Pain in the lower part of the abdomen, 
dysury, ischury, pain in the testes or lower extremities, 






Spinal Lesions. 125 

and disposition to paralysis. In only one case was there 
spasms of the stomach and retching. 

Twenty-three cases suffered with tenderness in all 
parts or segments of the spine. In these cases the patients 
were found to have a combination of the symptoms of all 
of the foregoing cases. 

Five cases of the 148 reported, exhibited no tenderness 
upon palpation of the spine, yet they suffered with the 
same disease as those that suffered with tenderness when 
palpated. 

At this same period — about 1834 — Swedish gymnasts 
observed among those suffering with cardiac diseases, 
tenderness over the fourth and fifth dorsal nerves, upon 
palpation. 

The Swedish school recognized definite areas of spinal 
tenderness associated with diseases of different organs. 

Tenderness over the sixth, seventh, and eighth dorsal 
nerves on the left side, was associated with stomach 
troubles. 

In 1841 a memorable work was published by Marshall 
Hall, which established the importance of the spinal 
reflexes. The above information was gleaned from 
Spondylotherapy by Dr. Albert Abrams, of San Francisco, 
who has done humanity a blessing by his able work and 
writings. 

An interesting article is furnished us by T. E. Williams, 
M. D., of Eau Claire, Wisconsin, concerning some atten- 
tion given to the subject of spinal lesions and spinal 
treatment, in the years 1828 to 1851, which article follows: 

In the past few years I have been looking through 
the literature of many of the older authors on medicine 
and surgery, hoping by so doing to find someone who at 
least observed something, if only in part, teaching on 
subluxation of the vertebrae and adjustment of the same. 

In gleaning here and there through a large number 
of old volumes, written many years ago, on diagnosis, 



126 Interference With Nerve Function. 

medical practice, surgery, and neurology, I found the 
field, with the exception of the writings of two medical 
men, who briefly referred to the principles embodied in 
spinal adjustment, quite barren; and that which I found 
on the subject came from Scotch and English authors. 

The two medical men mentioned had certainly 
grasped the true idea of spinal lesions in as modern a 
way as our Dr. Gregory, or any of the rest of our leading 
thinkers, and what they have said on the subject was to 
the point. In fact, these two men were strong and vigor- 
ous adherents of the fact that spinal lesions are etiological 
factors, as far as the light of the age in which they lived 
permitted. I will proceed, that you may know who they 
were, and also what they had to say. 

There appeared an article on "Irritation of the 
Spinal Nerve," by Thos. Brown, M. D., in the Glasgow 
Medical Journal, Vol. I, page 131, 1828, in which Dr. 
Brown makes the following statement in a straightfor- 
ward manner: "The immediate cause is spasm of one 
or the other of the muscles arranged along the spine, 
altering the position of the vertebrae, or otherwise com- 
pressing the nerves as they issue from the spinal marrow." 

Most of us can fully agree with Dr. Brown's state- 
ment, that minor subluxations of the vertebrae and com- 
pression of nerve sheaths offer sufficient cause to bring 
about "irritation of the spinal nerves," as well as affect 
the nerves in the remote parts of the body. 

I now wish to call your attention to a statement 
made by another author in Guy's Hospital, London, 
England, in clinical lectures on "Rest and Pain," namely, 
Dr. Hilton. In the following statement by Dr. Hilton 
we will find something of practical interest and diagnostic 
value. Now listen: "If a patient complains of pain on 
the surface of the body, it must be expressed by the 
nerve which resides there; there is no other structure 
that can express it, and somewhere in the course of its 



Spinal Lesions. 127 

distribution, between its peripheral termination and its 
central, spinal or cerebral origin, is where the precise 
cause of pain, expressed on the surface, must be situated." 

We quote you one of his cases and the method he 
employed in adjusting a vertebra: "On the 18th of 
March, 1851, Mr. Ray, of Dulwich, brought me a boy 
eight years of age, who had been suffering from severe 
pain during January and February, just above the pit 
of the stomach, and who used to walk about with his 
hands placed over that region, with the body inclined a 
little forwards as if suffering from some irritation or 
pain, of some of the abdominal organs, in which the 
treatment had hitherto been chiefly supplied, but without 
much benefit. It was noticed that the pain was increased 
during the maintenance of the erect posture, and that it 
was relieved by the recumbent position. The child was 
old enough to express a little of what he felt, and when 
asked where the pain was, he put both his hands over 
the stomach, where he had previously complained of 
pain; and we observed that the pain was expressed on 
both sides alike. I requested that he might be undressed 
so that we might examine the spine. We now found that 
there was tenderness and slight displacement between 
the sixth and seventh dorsal vertebra?, and pressure 
upon these vertebrae produced the pain in front. The 
real cause of the patient's symptoms was now apparent, 
and spinal rest for three or four months upon a hair 
mattress, cured him." 

The language of the two medical men in 1828 and 
1851, and that of the modern chiropractors, are remark- 
ably similar in their characteristic expression. 

In the London Hospital, in 1894, Sir Wm. Gowers, the 
eminent neurologist, said, that "function depends upon 
the release of force — nerve force." This last statement 
conveys more than an ordinary meaning to those engaged 
in spinal adjustment, for that is the very thing they 



128 Interference With Nerve Function. 

claim to do, and do it to the satisfaction of nearly every- 
one who takes spinal adjustment. 

In our study of this subject, we will confine ourselves 
more especially to a consideration of the minor lesions 
of the spinal column that interfere with the nerve sheaths 
coming out from the spinal neural canal. These lesions 
are best discovered by palpation, and are discernible 
only to the palpators with trained fingers in this line of 
work, but their importance renders the painstaking 
practice necessary to discover the existence of these 
minor lesions, well worthy of our consideration and 
patience. 

I do not know of any subject that is of more impor- 
tance and more interest to us than this one. I do not 
believe there is any subject as poorly understood, or 
understood by so few, as this one. I do not believe any 
other subject has been as erroneously presented to the 
attention of the people generally, as this subject by those 
who practice spinal adjustment. 

Some of our intelligent surgeons and physicians con- 
sider spinal lesions an impossibility, except complete 
subluxations. They do not consider that there is any 
relation existing between ordinary disease and its cause, 
and spinal lesions. 

There are others, especially among those of the 
osteopathic and chiropractic persuasion, who believe that 
these lesions are associated with all disease, both acute 
and chronic, and some go so far as to believe that spinal 
lesions and the consequent nerve impingement are the 
primary, absolute, and sole cause of all disease, acute and 
chronic. 

The idea that a great many of these people have of 
the nature of spinal lesions, is, to the mind of the writer, 
7ery erroneous. 

Now what are spinal lesions? I believe a good defini- 






Spinal Lesions. 129 

tion for a subluxation or spinal lesion would be this: 
Any deviation from the normal approximation of adjacent 
vertebrce. We find that people generally possess a mis- 
understanding of the meaning of the term subluxation. 
Many do not seem to understand the difference in the 
meaning between the term subluxation and luxation. 
They seem to consider that a subluxation is a luxation, 
but that it consists of a smaller degree of malposition. 

We should ever bear in mind, when speaking of a 
subluxation, that the term when applied to a vertebra, 
does not mean a luxation thereof but merely a deviation 
of it from its normal relation and approximation to 
adjacent vertebrae. It is evidently a fact that subluxa- 
tions that interfere with nerves most, are approximations 
of vertebras of such a nature as would narrow the inter- 
vertebral foramina. 

The above would not only be the common cause, but 
the only way lesions would cause interference with the 
spinal windows — except contractions of ligaments which 
would slightly rotate a vertebrae upon its axis. 

The foramina along the spine are formed by the 
notches in the pedicles of the vertebrae. Each pedicle 
has a notch on both its superior and inferior edges. The 
superior notch in the pedicle of one vertebra is, or should 
be, even with the notch in the inferior surface of the 
pedicle of the vertebra above. 

The most natural cause of a lesion, therefore, would be 
an approximation. The manner in which the spine is 
built, the different sets of ligaments that hold it in place, 
would almost preclude the idea of a vertebra slipping to 
one side, and in this way interfering with the size of the 
foramina or nerve sheaths. 

If vertebrae are approximated, this would be in per- 
fect keeping with the law of contraction of the tendons, 
muscles, and ligaments. Consequently, the most common 



130 



Interference With Nerve Function. 



cause of lesions is the contraction of the tendons, muscles, 
and ligaments of the spine or spinal musculature. 

The contraction of the spine may affect one side, or 
it may affect both sides. It may be on the anterior or 
on the posterior surface of the spinal column. We may 
have a combination of an anterior or posterior and the 
lateral approximation. 

We have vertebrae one above the other, and the 
cartilages in between holding them apart. The cartilages 
are normally as thick on one side as on the other. Imagine 




Illustration showing both unilateral and general thinning of the inter- 
vertebral cartilages between the centrums of the vertebra. (Courtesy 
M. E. Clark.) 



Spinal Lesions. 



131 



one vertebra being directly above the one adjacent below 
it. Imagine a contraction of ligaments on one side, and 
you will have an impingement of the cartilage on the 
same side, and a lateral approximation of the centrums 
of the vertebrae, upon the same side, and a consequent 
narrowing of the foramen. 

Not only do we have this impingement upon the one 
side, but we have an apparent malalignment of the 




Illustration showing how unilateral or general contraction of the lig- 
aments or settling of the spine will interfere with the integrity of inter- 
vertebral foramina. (Courtesy M. E. Clark.) 



132 Interference With Nerve Function. 

spinous processes, because as the vertebrae approximate 
on one side, the spinous processes will show it by their 
positions and their failure to be in normal alignment. If 
you have a contraction on both sides, there is only an 
approximation of the processes and centrums instead of 
a malalignment. 



CHAPTER VI. 
CAUSES OF SPINAL LESIONS. 

THERE is not only a failure on the part of the laity 
but also a failure on the part of the practitioners 
of the healing art generally to recognize spinal 
lesions and their importance as etiological factors in 
disease. 

For the above reason there has been but little atten- 
tion given to the subject of the cause of spinal lesions, 
notwithstanding the fact that the subject of the cause of 
spinal lesions is one of great importance. 

This subject is not understood properly by many of 
the practitioners of spinal adjustment, and for the above 
reasons we feel the necessity of considering this subject 
more thoroughly in this chapter. 

We enumerate below some of the more important 
causes of spinal lesions which act directly upon the 
spinal column or spinal tissues or musculature. 

An important question is, what causes these ligaments 
to contract? I will enumerate some of the causes, under 
the following heads: 

I. Jars. 
II. Falls. 

III. Blows. 

IV. Strains. 
V. Settling. 

VI. Twisting. 
VII. Muscle tire. 
Under these heads I have tried to enumerate the 
principal causes acting directly upon the spinal column 
and causing lesions thereof. It is necessary to make a 
few remarks explaining how and why these causes will 
produce spinal lesions. 

133 



134 Interference With Nerve Function. 

I. Jars. — Jars, because of their violence, may injure 
the spinal tissues, and thus cause their contraction. 

Continuous jarring, as riding on a train, will cause a 
settling of the spinal column and thinning of inter- 
vertebral cartilages. 

Engineers are liable to be affected with certain ail- 
ments which are associated more especially with a 
settling of the spine and consequent interference with 
the lumbar nerves. This seems to be the result of the 
continuous jolting and settling, incident to their occupa- 
tion, and also the greater amount of the superimposed 
weight of the body upon the lumbar vertebrae. 

II. Falls. — A fall of any violence is liable to injure 
the musculature of the spine, and thus cause a decided 
irritation and contraction of the spinal musculature. 
Many cases have come to the attention of the author 
during the last three or four years that date their trouble 
back to some fall which produced a lesion of the vertebral 
column. One case was that of a man who had fallen 
from a pitching horse. He was thrown several feet in 
the air, and alighted upon the upper part of the thoracic 
portion of the spinal column. As a result of this fall he 
suffered for several years until he fell into the hands of 
the author, when he was relieved of any further difficulty 
with the nerves and functions of the viscera of the 
thoracic cavity, which were interfered with by lesions 
from the fall. 

One case that came under our attention was that of 
a lady who, at the age of 18 years, had fallen from a 
wagon on a public road. The worst lesion produced by 
this fall was in the lower portion of the thoracic region of 
the spinal column. As a result of these lesions, and inter- 
ference with the nerves of this part of the spine, she had 
a prolapsed or floating kidney on each side. She lived 
in this condition a number of years, but was practically 
an invalid a great portion of the time. The physician 



Causes of Spinal Lesions. 135 

who attended her could not believe that it was the kidneys 
that were palpated so low in the abdominal cavity as he 
found them. Her life was finally despaired of, and in 
that condition she came to our office. 

By relieving the contractions in the lower thoracic 
region, we restored the nerve supply and tonicity to 
support of the kidney and she was restored to health, 
and the kidneys were restored to their normal condition, 
and now after a period of over three years she is strong, 
robust, and in better health than she has been since the 
occurrence of the accident. 

On the other hand, falls have done patients good. 
We have read of cases in which the trouble was relieved 
by a fall. Cases of this kind seem to be miraculous. 
Since we hear of so many cases being relieved by a fall, 
there must be a reason, and that evidently is due to the 
fact that some contracted portion of the spine is loosened, 
and the nerves that have been impinged are freed, and 
thus normal function is restored. 

It seems a pity, however, that practitioners of the 
healing art have given so little attention to spinal lesions, 
as to have to leave these patients unaided until they 
accidentally fall downstairs to get well. 

III. Blows. — Blows which injure the musculature of 
the spinal column may cause contraction of the muscles 
and ligaments of the spine because of the contractured 
condition that follows irritative or traumatic lesions. 
Blows must be of sufficient force to injure the muscula- 
ture of the spine before they become an exciting cause of 
spinal lesions. Blows which injure, irritate, or excite 
peripheral endings of any of the afferent nerves, may 
reflexly cause spinal contractions and consequent lesions. 

IV. Strains. — Strains are another cause of spinal 
lesions. A strain of the ligaments or tendons of the 
spinal musculature will injure, rupture, or break the 
fibrilla of the tendons or ligaments. 



136 Interference With Nerve Function. 

A strain will excite an irritation and cause a contrac- 
tion of the musculature of the spine, especially of that 
portion of the tissues which is injured by it. Ligaments 
and tendons so injured will contract and approximate 
vertebrae, causing impingement of nerves; and heavy 
impingement will cause decided derangement of function 
and often intense pain. 

If a person is lifting in a strained position, he is apt 
to injure the ligaments of the spinal column, more espe- 
cially those of the lumbar region. An injury of the muscu- 
lature of the spine, in the lumbar region, or elsewhere, 
will cause what is known as a "catch in the back." This 
condition will often come on very quickly after a violent 
strain and injury of the musculature of the spine. 

It seems that the contraction of the tissues of the 
spinal column is a very sudden occurrence, resulting from 
an irritative injury to the connecting tissues of the verte- 
brae of the spinal column. Sprains of the joints of any 
part of the body and of the extremities, will affect the 
spinal column because of the reflex contractions pro- 
duced by the painful irritation of the afferent nerve 
endings in the joint or part that is injured. 

V. Settling of the Spine. — The settled shortened 
condition of the spinal column is a condition coming on 
slowly and is most common among people in the decline 
of life. The spinal column of many chronic sufferers may 
become reflexly involved. They become stooped, curved, 
and shortened as the result of contraction of the muscu- 
lature of local segments of the spine. 

Actual measurements taken of people when they are 
just reaching full development, and measurements of the 
same persons when they have reached the age of sixty 
or seventy years, show that the great majority of people 
become from one and a half to three inches shorter when 
they grow old. 



Causes of Spinal Lesions. 



137 



This shortening is at the expense of the intervertebral 
cartilages in most all cases, especially that coming on as 
the patient advances in years. The settling of the spine 
takes place very gradually. 

It is a well-known fact, that we settle in height every 
day to a greater or less extent, during the time from 
rising in the morning until going to bed at night. The 



Spinal Cord 



NORMAL 
NE.RVE. 



L\T 




SPINAL 

WINDOWS 

OPEN 



RMAL 
CARTILAGES 



Illustration showing the normal intervertebral discs, the open spinal 
windows, and the normal nerve sheath, with the nerve and artery normal in 
size. (Exaggerated.) (Courtesy S. C. Mathews.) 



138 



Interference With Nerve Function. 



more laborious our work, the more our muscular exercises, 
and muscle tire, the more consequent settling in height 
will take place. 

This is due to the result of muscle tire because of 
overwork, especially if it causes a depression of the 
tonicity of the erector muscles of the spine. This muscle 
tire permits of an excessive settling of the spine. 

If we take a careful measurement of our height in 
the morning, we will find that we have increased in height 
during the rest and relaxation of the night. 

During the early years of life, when our rest is perfect, 



SPINAL CORD 



Spinal 
windows 

PARTLY 
CLOSED 



abnormal 
nerve: 




Illustration showing an extremely settled condition of the spine. The 
intervertebral discs are very thin, and the spinal windows are narrowed. 
The spinal nerve and the artery are impinged and reduced in size. This is 
a condition coming on with age. (Exaggerated.) (Courtesy S. C. Mathews.) 



Causes of Spinal Lesions. 139 

the relaxation and expansion of the night will overcome 
the settling of the spine during the preceding day. For 
this reason as the years go by during the stage of develop- 
ment, we will lose nothing in height. While we are 
young and growing we will gradually increase in height 
and in the length of the spine, and there will be no 
shortening of the spinal column take place until we have 
passed the meridian of life. 

Age Comes Ox. — This condition of youth does not 
always continue, we finally reach the zenith of our 
strength and development. When we enter upon the 
decline of life we will become more exhausted as the result 
of a day's work, there will be more of the settling of 
the spine, because of the increased exhaustion. At the 
same time we find that a person will begin to fail to sleep 
and rest and the relaxation will not be so perfect as in 
his youthful days. 

The expansion and relaxation of the spine, occurring 
during the night, does not compensate for the settling 
of the spine during the previous day. The difference 
between the settling of the day and the expansion of 
the night is imperceptible in amount. An accumulation 
of the imperceptible differences of the settling and the 
expansion of the daily cycle, will, as the years roll by, 
tell in inches, in the height, as the patient grows old. 

The more excessive the muscle tire from a day's 
laborious work,- the more settling of the spine will occur. 
Muscle fatigue beyond a certain amount becomes a 
pathogenic factor. 

As the years pass by, and as the spinal column 
becomes shortened, we know that the shortening is 
wholly at the expense of the intervertebral cartilages. 
The bones of the legs will not shorten; the vertebra of 
the spine will not become compressed; the shortening 
of the patient and the spinal column is wholly at the 



140 Interference With Nerve Function. 

expense or the result of a decrease in the thickness of 
the intervertebral cartilages. 

After the settling that has taken place during the 
years of a person's life, that has not been compensated 
for by expansion, the spine will become shortened. The 
combined thickness of all of the intervertebral discs is, 
on an average, about one fourth of the entire length of 
the spinal column, exclusive of the first two cervical 
vertebrae. 

Since the shortening of the spine is at the expense of 
the intervertebral cartilages, the shortening occurs in 
proportion to this thinning. As the intervertebral 
cartilages grow thinner, the intervertebral foramina 
become narrowed; the sheath that contains the nerves, 
arteries, veins, lymphatics, etc., becomes slightly impinged 
and occluded. 

The patient has probably lost nearly half of the 
vertical dimensions of the intervertebral foramina, and 
the nutrient supply and the drainage of the spinal seg- 
ments are interfered with throughout most of the length 
of the spinal column in proportion to the occlusion of the 
neural sheath. 

When spinal settling begins to cut off or narrow the 
channels of the life force either by interfering with the 
nutrient vessels, by cutting off the circulation to the 
nerve centers, or by interference with the nerves as a 
result of compassion or impingement — we begin to have 
interference with the transmission of the normal impulse 
and deranged function to the organs supplied. 

You will find that the old man's organs and viscera 
do not function normally; the heart does not do its work 
well; the kidneys are not performing their functions 
normally; the nerve supply to the bowels is not free and 
normal, and we have a general hypo-tonicity of both the 
muscular walls and the glandular coats of the bowels. 
There is a general paralytic condition present, and as a 



Causes of Spinal Lesions. 141 

result of the non-excitability of the afferent nerve endings 
and the lack of the peristaltic and secretory reflexes 
resulting, many suffer with chronic constipation. 

Here is a field for the practitioner of spinal treatment. 
It falls to the lot of some practitioners to prevent the 
unfavorable effects of the settling of time upon the spine 
of the aged. We have been able to accomplish much 
good along this line of work. If the spinal nerve supply 
is kept normal and the tonicity of the erector muscles of 
the spine is maintained, the spine will be retained in a 
normal condition much better than when there is a lack 
of muscle tone. Muscle tire and exhaustion will depress 
the muscle tone, and will always permit more or less 
settling to take place. 

We have a compensatory change that takes place in 
the spine as age comes on, which consists of an alteration 
in the conformity of the normal spinal curvature, which 
in a way provides for the nerves in the settling of the 
spine, by preventing the narrowing of the spinal foramina. 
This change is simply a forward bending of the spine. 

By an examination of the bones of the spinal column, 
and especially if you notice the superior articular pro- 
cesses of the vertebrae, you will see how the processes of 
the vertebras below pass up over the foramina above. 
You will then understand that by a backward bending 
how the articular processes are forced into the foramina 
and how they partially obliterate them. 

The forward bending, however, will move the articular 
process backward instead of forward. In this way, the 
spinal openings are not so much interfered with. The 
intervertebral cartilages will be thinned between the 
anterior portions of the centrums of the vertebrae, while 
the cartilages between the posterior portions will not be 
so thinned, and hence the forward curve of the spine of 
the old man compensates in a great measure for the 
settling of the spine coming on with age. 



142 Interference With Nerve Function. 

VI. Twisting. — Twisting of the spinal column may 
engender interference with nerves, and the twisting may 
be induced in several different ways: 

A wrench of the spine in a rotary manner brings a 
great strain to bear upon the ligaments that hold the 
vertebrae in approximation. 

Injury to ligaments, tendons, or any of the tissues of 
the spine, will cause contraction, it matters not in what 
way the injury is produced. 

During life a great many people take very little 
exercise, or make but few movements that call into 
action the musculature of all parts of the spinal column. 
For this reason the musculature of the spine is unde- 
veloped, and is not strengthened. Patients who lie 
in bed a great deal of the time without using the erector 
muscles of the spine to hold them in an upright position, 
or when they do not exercise any of the muscles of the 
spine, the entire musculature of the spine becomes 
weakened. In such cases, the mere act of turning in 
bed might possibly stretch or injure the ligamentous 
bands that bind together the vertebras. The injury 
might be of sufficient magnitude to cause a contraction 
and what is termed a "subluxation." 

To people in active life, who bring into play the 
musculature of the spine more or less by reason of their 
occupations, there is little danger ordinarily of twisting 
or bending of the spine having much influence or detri- 
mental effects upon the rectitude and integrity of the 
spinal column. Violent twisting, however, may produce 
lesions of even the well-developed spines. 

Exercises that bring into play the musculature of the 
spinal column, will tend to strengthen and to protect the 
spinal tissues from injury because of any internal violence 
or wrenching. We notice examples of this in professional 
wrestlers. In some occupations people will allow their 
spines to be held in a certain twisted or bent condition. 



Causes of Spinal Lesions. 143 

Abnormal conditions of the spine that are main- 
tained for a sufficient length of time, will lead to con- 
structive changes in all of the tissues pertaining to the 
spinal column. The intervertebral cartilages will become 
thinned on one side, and thickened on the other; the 
muscles will become shortened on one side and lengthened 
on the other, until there is a permanent deformity of 
the normal outline and conformation of the spinal column. 
We have examples of this in people who work at desks, 
with one shoulder held higher than the other, and we 
also see examples of this in case of chronic pain or afflic- 
tion. 

VII. Muscle Tire. — Fatigue of the muscles, espe- 
cially of the erector muscles of the spinal column, is a 
direct cause of the settling of the spinal column. Fatigue 
of the muscles of the spine is responsible for the shorten- 
ing that takes place during the day's exercises. 

Massage, or vibration of the muscular tissues of the 
spinal column, will relieve the tired feeling that comes as 
a result of the general fagging and settling due to muscle 
tire. 

Thrusts, to overcome the settling that has taken 
place during a hard day's work, which affect the inter- 
vertebral cartilages, will re-establish nourishment to the 
different segments of the spinal column, will restore 
nerve impulses of normal magnitude and quickly relieve 
the tired feeling. 

The fact that massage, vibration or thrusts given to 
open up spinal articulations, will relieve the tired feeling, 
proves that the tired feeling is the result of spinal settling 
and of the mild interference with the nutrition or drainage 
of the spinal cord, and consequent depressed nerve tone. 

We know that any alteration in the nutrient supply 
or drainage to and from the segments of the spinal cord, 
affects both the reflex transmission of afferent impulses 



144 Interference With Nerve Function. 

and the generation and distribution of the physiological 
stimuli that is continually going on. 

In the case of a slight settling of the spinal column 
from a day's work, no doubt the venous channels are 
mostly interfered with. The walls of the venous channels 
are less resistant than are those of the arteries and 
nerves, and for this reason a slight narrowing of the 
intervertebral foramina will affect first the venous drain- 
age of the spinal segments. The venous supply of these 
segments is laden more or less with the chemical by- 
products of muscular activity, and these facts account 
for the depressing effect upon the spinal centers. 

There are conditions existing in some youths in which 
there is a general hypo-tonicity of the musculature of the 
spinal column. For this reason the spine will settle and 
curve, and we find young people with spinal curvature 
apparently due to this reason. 

In our experience in spinal treatment we find that 
after opening up the spinal articulations of the different 
regions of the spine in which the abnormal curvature 
exists, that the patient will stand erect, which is no 
doubt due to the re-establishment of the normal nutrient 
supply, and the normal channels of drainage, which 
engender normal physiological nerve impulse, and the 
normal reflex transfer of all afferent impressions; conse- 
quently the normal tonicity is restored to the musculature 
of the spine, which musculature maintains the spine in 
the erect and proper position. 



CHAPTER VII. 
REFLEX SPINAL LESIONS. 

IN this chapter we wish to consider a subject that has 
been almost wholly overlooked by practitioners of 

the healing art. We know of no literature extant 
that goes into a study of the subject of reflex spinal 
lesions. There is probably no more important, nor more 
constant, nor more potent agency in the development 
of pathological processes of acute disease, and in the 
continuation and development of chronic disease, than 
spinal lesions produced by reflex contractions. 

Nine tenths of all spinal lesions of a minor nature 
which interfere with nerve function, are produced through 
the agency of the reflex action of the nervous system. 
Many who have made a study of spinal lesions and of 
spinal adjustment, have disputed the fact of the pheno- 
mena of reflex action. This act on their part has blinded 
their eyes to the true philosophy of spinal lesions and 
spinal treatment, and to-day the majority of those prac- 
ticing spinal adjustment are almost wholly ignorant 
of the underlying principles of chiropractic spondylo- 
therapy because of their erroneous ideas and teaching. 

No one without a correct knowledge of the existence 
and influence of the reflex cycle phenomenon, can ever 
account for the many spinal lesions that are ever occurring 
in connection with acute disease. That we may be able 
to more easily comprehend the phenomenon of reflex 
action which is the most common cause of spinal lesions, 
we will first consider for a moment the reflex apparatus 
and the reflex phenomenon. The elements necessary to 
the reflex cycle are as follows: 

1. A stimulus. 

2. A receptive apparatus. 

145 



146 Interference With Nerve Function. 

3. An afferent conduction tract. 

4. A central transferring station. 

5. An efferent tract of conduction. 

6. Terminal organs or tissues supplied. 

7. Terminal nerve end-organs in tissues. 

The reflex phenomenon consists of an afferent impulse 
and central transfer, and an efferent impulse and action 
depending upon the nature of the tissues in which the 
centrifugal impulse terminates. 

1. Afferent nerves are prepared for the reception of 
an impulse at their peripheral endings. 

2. Every afferent nerve has its own special reflex 
center in the gray matter of the spinal cord. 

3. The efferent nerves are prepared for the reception 
of centrifugal impulses at their central ends. 

4. The specific energy or nerve impulse travels over 
the entire length of the afferent tract from its peripheral 
end apparatus to its central termination. 

5. This impulse, that is then transferred from the 
afferent to the efferent nerve, then passes over the entire 
length of the efferent motor nerve tract from its spinal 
origin to its end-organ. 

Since the afferent impulse must be carried from the 
periphery to the center by means of the sensory nerves, 
the entire length of that nerve is thrown into a state of 
excitability during the reception and conduction of the 
impulse. 

The impulse after being transferred to the efferent 
nerve, travels over its entire length, from its spinal 
center to its peripheral end-organ. The entire motor 
nerve then is thrown into a state of excitability and 
action. 

One important fact should be remembered in this 
connection: Since the entire motor tract is thrown into 
a state of excitability by reason of the return conduction 
of the reflexed impulse, all of its branches will be thrown 



Reflex Spinal Lesions. 147 

into a state of excitability, and action will be produced 
in the tissues in which they terminate. 

The ordinary arrangement of the spinal nerve is that 
after emerging from the spine, it divides after the follow- 
ing plan: 

The first branch given off is the primary posterior 
branch, or division. 

Another branch given off, especially throughout the 
thoracic region, is the white rami communicantes to the 
relative ganglion of the sympathetic cord. 

Of the remainder of the nerve is formed the anterior 
primary division of the spinal nerve, which in the thoracic 
region supplies the intercostal muscles and intercostal 
space. 

During the course of this nerve, it gives off the lateral 
cutaneous branch which divides into an anterior and a 
posterior division supplying the cutaneous surface over 
the corresponding intercostal space. 

The most important branch of the spinal nerve relative 
to causing spinal lesions is the posterior primary division 
that ramifies and supplies the musculature of the relative 
segment of the spinal column. 

Following an impulse from the transfer station of 
the reflex center in the spinal column, we find the root 
and central end of the motor nerve first thrown into a 
state of excitement. The primary posterior branch of 
the spinal nerve is the first nerve branch that the impulse 
will reach, and consequently the first branch to produce 
action in the tissues in which it terminates. 

The impulse traveling further along on the efferent 
nerve, will reach the peripheral end of the primary 
anterior division, and produce action in the zone supplied. 
The first effect, then, of an efferent reflex impulse, is an 
excitation of the nerves to the musculature of the spine. 

The action produced by the peripheral endings of the 
anterior primary division is a secondary phenomenon, 



148 Interference With Nerve Function. 

For an example, we will consider the act of putting our 
finger on a hot stove, when we are not aware that the 
stove is hot. The finger comes away before we know it. 
Now, what has happened? An impulse of excitation has 
passed over the afferent nerve to that nerve's special 
center in the gray matter of the spinal cord. It is trans- 
ferred to the motor nerve; it is transmitted back, and 
contracts the muscles of the fingers and jerks them away. 
This action takes place so quickly that this same impulse, 
or that part of it which has been sent to the brain, does 
not reach the centers of intelligence, and is not inter- 
preted by the brain until after the hand is taken away; 
but there is something else happening at the same 
instant in connection with this phenomenon. 

That impulse has had to travel the entire route of 
the afferent nerve, and after being transferred has had 
to travel the entire span of the efferent nerves, and it 
excites action in all branches along its efferent route of 
transmissions. 

The first branch of the efferent nerve is the posterior 
primary division, and it ramifies and supplies the muscu- 
lature of the spine and the next branches to the muscles 
of the arm that is in the brachial plexus. 

Now this impulse that has been generated because of 
the irritative influence caused by the excessive heat, and 
traveling, as it does, over the entire length of both 
afferent and efferent nerves, has thrown into a state of 
excitement all the branches of that efferent nerve; con- 
sequently we find that not only are the muscles of the 
finger contracted, but also the muscles of the arm and 
the muscles of the shoulder are contracted. But first, 
and before this has occurred, the posterior primary division 
has been excited and the musculature of the spine has 
contracted. 

The action produced by the efferent nerves always 
corresponds to the tissues in which the centrifugal 



Reflex Spinal Lesions. 149 

impulse ends. If the afferent impulse ends in glands, it 
will produce secretion or excretion; if in muscles, con- 
traction; and as the posterior primary division of the 
nerve ends in the musculature of the spine, the effect 
produced is, of necessity, contraction, and that means 
contraction of the musculature of the spine. 

Since the impulse reaches the primary posterior 
division of the spinal nerve first, the contraction of the 
spinal musculature will precede the contraction of the 
muscles of the arm, and the contraction of the muscles of 
the arm will precede the contraction of the muscles of 
the finger, as the muscles of the finger are most peri- 
pheral, and consequently the impulse reaches them last. 

Any excitation or irritation of the afferent nerve 
endings will ever produce the reflex phenomenon, pro- 
vided the excitability and conductivity of afferent and 
efferent nerves are normal, and provided the reflex center 
of the nerve affected is intact and functioning normally. 

A great many agencies act as afferent nerve irritants; 
consequently we have constant influences and constant 
action upon the spine in many cases when we are entirely 
unaware or unmindful of the fact. 

Now, in presenting the above, we know we are present- 
ing something that is entirely new, and we are presenting 
something that we have never seen in writing or heard 
from the lips of any teacher. For that reason we feel 
justified in bringing some reasons to bear to show the 
correctness of the above conclusions. 

We have stated above that muscular contractions 
are produced because of impulses passing over efferent 
or motor nerves. The simple contraction of muscles will 
do them no harm; in fact, a normal amount of contrac- 
tion and relaxation is necessary to the development and 
maintenance of the strength of the muscular tissues, but 
we must not violate the physiological law of the contrac- 
tion of muscles by excessive action. 



150 Interference With Nerve Function. 

There are chemic and thermic changes that take 
place in muscular tissues as a result of their contraction. 
Continuous contraction will materially alter the condi- 
tion of the muscle. In the simple act of muscular con- 
traction, the muscle shortens, thickens, and becomes 
more condensed; or, in other words, its specific gravity is 
increased. 

Following an excessive and continued contraction, 
we get a condition of contraction remainder, or a con- 
tractured condition, because the muscle no longer dilates 
or expands to its normal length and condition, but owing 
to the toxic elements produced by the contraction, it 
remains shortened, contractured, indurated, and perhaps 
tender and sensitive. 

The muscles, ligaments, and tendons of the spinal 
column are of the same nature as are similar tissues of 
other portions of the body, hence contract and undergo 
similar changes and are affected in like manner. 

We may enumerate some of the more common 
causes of reflex contractions under the following: 
I. Burns. 
II. Strains. 

III. Wounds. 

IV. Irritation. 
V. Dampness. 

VI. Cold drafts. 
VII. Bacterial infection. 

The amount of the effect upon the spine in the way 
of producing lesions, depends upon the amount of irrita- 
tion that is produced by the application or contact of 
the exciting cause. 

For an irritant exciting an afferent nerve to produce 
a spinal lesion, it is necessary that this exciting influence 
be continued for a sufficient length of time to produce 
contractured conditions, for it is only after repeated reflex 
contractions that we have contraction remainder. 



Reflex Spinal Lesions. 151 

A continuous draft of air may give us a crick in the 
neck due to the continuous tonic contraction of the 
musculature of the spinal column in the cervical region. 

Following a sprain of the ankle joint, wrist or knee, 
we have as the result of the local irritation, a spinal con- 
traction affecting the integrity of the nerve supply to the 
injured part. Now this at first does not seem self-evident. 
We have repeatedly traced tender nerves to the spinal 
column from sprained ankles, sprained wrists, from 
abscesses, from boils, and from inflammatory zones in 
different parts of the body, and almost invariably find 
a contractured condition of the musculature of the spine 
at the point of the spinal origin of the nerve that supplies 
the zone of the lesion. 

When there is congestion, throbbing, and other 
unpleasant symptoms as a result of a sprain, we may, by 
relieving the contractured condition of the spinal column 
at the point of the spinal exit of the nerve supply to that 
part, entirely relieve the nerve and thus relieve all symp- 
toms and sensations of any pathological conditions or 
processes. 

One case that called on the author for treatment 
bears evidence to the truthfulness of the above concern- 
ing reflex spinal lesions in the form of contractions caus- 
ing impinged nerves. This case had suffered a fall of 
several feet from a bridge, and lighted upon a pile of 
rocks. One ankle was badly sprained and bruised. He 
was under the care of two physicians, who kept him 
under the influence of morphine for nine days on account 
of the severe pain. The pain, however, did not subside, 
and the patient could not rest, and claimed that he 
suffered all the time, notwithstanding the sedative effects 
of the medicine that had been administered. 

He was slow to believe that we could affect the ankle 
by spinal treatment. In order to convince his mind to 
the truth of the connection existing between the peri- 



152 Interference With Nerve Function. 

pheral lesion and the ankle, we carefully traced a tender 
nerve from the sprained ankle to the lumbar region of 
the spine. The tenderness of the nerve was quickly 
determined, and the path of the nerve was easily followed 
because of the sharp tenderness felt by the patient when 
the nerve was palpated. The tender nerve emanated 
from the spine in the lower portion of the lumbar region. 

A thrust was given to relieve the contractured muscu- 
lature of the spine, and the relief was almost immediate. 
In a few seconds' time he mentioned there was a tingling 
in that ankle, but in answer to our question informed us 
that the pain had entirely disappeared. Subsequent 
palpation along the track of the tender nerve soon after 
the adjustment showed that the tenderness of the nerve 
had almost entirely subsided. 

Some hot fomentations were applied to the ankle to 
relieve the paralytic condition of the blood vessels, or 
rather to assist the nerve supply in this relief, and the 
patient soon dropped off asleep. After three hours of 
perfect, absolute rest and deep sleep, he was awakened 
and sent home. The pain in the ankle did not return. 
Recovery took place rapidly, and the man returned to 
his labor and did not need further treatment. 

Often members of a ball team will sprain an ankle or 
wrist, and many of them have learned, by taking spinal 
adjustment, that the spine had become involved as 
a result of the peripheral afferent irritation. A thrust 
applied to overcome contractions at the spinal origin 
of the nerves from whence comes the direct nerve supply 
to the zone affected, would almost always give them 
immediate relief. The aching, throbbing, congested, 
and uneasy feeling would subside almost immediately 
after removal of interference with or impingement of 
the nerve at the point of its spinal exit. 

We have repeatedly demonstrated that there is a 
tender nerve existing and extending from all innamma- 



Reflex Spinal Lesions. 153 

tory and painful lesions back to the spinal exit of the 
nerve supplying the point irritated. We have repeatedly 
proven that the pain existing in such cases was due to 
that contraction at the spinal exit of the nerve, causing 
a slight impingement of the nerve. 

Any strong irritant to the peripheral endings of 
afferent nerves will excite the reflex conditions, and 
consequently produce spinal lesions — provided the irrita- 
tive or exciting influence is of sufficient magnitude — and 
is continued for a sufficient length of time. 

It is the excessive tonic contraction of muscles that 
produces the permanent shortened and contractured 
condition of them. 

The toxins of pathogenic bacteria have a decided 
effect upon the sensory peripheral nerve endings. They 
excite, as noted above, the thermogenetic activity of the 
nerves affected. They also excite spinal contraction. 

As a rule, infections will affect certain parts of the 
body. For example: Scarlet fever and diphtheria affect 
the throat tissues and muscles of the upper air passages 
involved. Typhoid fever affects the small intestines and 
the spleen. 

When a bacterial infection of an infectious or con- 
tagious disease attacks its point of predilection in the 
patient, we will soon have the production of toxins. 
The effects of these toxins are very decided upon the 
sensory nerve endings in the zone of the affection. Spinal 
tenderness is at once evident. A close palpation of the 
spinal column will often determine the location, and 
consequently we may judge the nature of an infectious 
disease because of the zone of its habitat. 

Catarrhal inflammation, or pneumococcus infection of 
the appendix, will cause a spinal contraction at the exit 
of the second lumbar nerve on the right side of the spinal 
column. 

An infection of typhoid fever will, because of the 



154 Interference With Nerve Function. 

toxic excitation of the peripheral sensory nerves, cause 
contraction at two portions or segments of the spine: 
One point in the spine is where the principal nerves 
supplying the small intestines make their exit; while the 
other point of contraction is where the nerves supplying 
the spleen pass from the spinal neural canal. 

In the case of diphtheria or scarlet fever, we find 
tenderness in the upper thoracic region corresponding to 
the origin of the spinal nerves which send white rami 
communicantes to the region of the throat. 

It is possible to make a diagnosis of a contagious or 
infectious disease by spinal palpation, provided we under- 
stand how and where the toxic effects of the germ prod- 
ucts of the different diseases produce reflexly the spinal 
lesions by reflex contraction. The author remembers a 
case that came into the office, that will illustrate this 
point: It was a former patient, who came for consulta- 
tion, and she was suffering with a high fever. Being 
acquainted at our office, she went at once to the treat- 
ment room and dressed herself for spinal examination. 

Palpation of the spinal column elicited tenderness at 
the point of the spinal exit of the nerve supply to the 
spleen, and also at the point of exit of the nerve supply 
to the small intestines. After a careful palpation of all 
other portions of the spine with negative results, a 
diagnosis of typhoid fever was made. A subsequent 
inquiry into the history of the case, developed unmistak- 
ably that the diagnosis was correct. 

We have often diagnosed appendicitis by reason of a 
knowledge of the reflex effects upon the spinal column 
that result from the disease when in a painful or inflamed 
condition. 

We are confident that no inflammatory or infectious 
zone can exist anywhere in the body without producing 
perceptible results upon the spinal column. Persons 



Reflex Spinal Lesions. 155 

with trained fingers and brains will verify the truthfulness 
of this statement in any case. 

Atmospheric Influence. — For a long time we have 
known that before approaching storms and before changes 
in the weather, and especially before rains and stormy 
periods, almost all rheumatics increase their complaining. 
Some people are very good barometers of the weather. 
Did you ever wonder why this is so? 

Undoubtedly there is something in the condition of 
the atmosphere, in the moisture, or in the electric condi- 
tion thereof, in the position of the planets, or something 
else, that has an influence upon the muscles, ligaments, 
and tendons of the spine. Something of this nature 
must account for the changes which take place in the 
patient's condition — especially rheumatics — just previous 
to a storm. There is something in the atmospheric condi- 
tion surrounding the patient that is responsible for the 
change in the contractility of the musculature of the 
spinal column. 

There is a manifest difference between the atmospheric 
condition during the day, and that during the night. 
Ordinarily, a patient will suffer more at night than in 
the day time, from the unfavorable symptoms connected 
with different forms of disease, acute or chronic. Patients 
usually complain that the pains are worse at night than 
in the day time. One reason for this is, that the patient 
becomes quiet at night and is liable to forget his work 
and to think only of his trouble. This will magnify the 
pain, and this is, no doubt, the reason why the patient 
is more sensitive to, and suffers with pain more, at night. 

When the mind is drawn entirely away from the pain, 
or from the cause that produces it, we feel but little pain, 
but if we are expecting pain, the mind is centered upon 
it, and the pain will be intensified. There is no doubt 
of the truth that pain is in many cases really worse at 



156 Interference With Nerve Function. 

night because of atmospheric changes, as well as worse 
before certain changes in the weather. 

There is another feature concerning the attitude of 
the patient during the night, that tends to give relief. 
The rest and relaxation of the spine tend to relieve inter- 
ference with nerves, because of the tendency to over- 
come the settling of the previous day. As a result of 
the night's rest, our patient will feel better in the 
morning, usually. 

Undoubtedly during the night, and preceding elec- 
trical storms accompanying falling weather, the unfavor- 
able symptoms connected with our patients are due to 
some change in the amount of electricity, moisture, or 
temperature of the atmosphere around us, which affects 
the nervous system and the musculature of the spinal 
column. 

The effects must produce some contractions of these 
tissues that will slightly increase a partial impingement, 
and consequently increase the pain of a nerve that is 
already slightly impinged. 

Influence of Altitude. — I have observed that in 
different altitudes there were differences in the spinal 
condition of patients. In mountainous regions in conse- 
quence of the atmospheric conditions, there is produced 
a perceptible change in the tonicity and tension of the 
articular ligaments and other muscular tissues of the 
spinal column. 

In giving spinal adjustments to patients in moun- 
tainous regions, I find that on an average it takes a more 
forcible thrust to open up the spinal articulations, than 
is necessary in regions nearer the sea level. 

The skin does not act so freely in the cooler mountain 
regions, as it does in the warmer and more humid atmos- 
pheres; hence, perspiration is much less in quantity. We 
have noticed, also, when visiting in mountain regions, 
that we seldom perspire in perceptible quantities. The 



Reflex Spinal Lesions. 157 

failure of skin action in mountain regions becomes a 
direct cause of excessive elimination through the kidneys, 
and consequently kidney overwork, with a resulting 
derangement of kidney function and disease. 

In making examinations of a number of cases in a 
doctor's office in Trinidad, Colorado, I found the great 
majority of patients suffering with kidney disease, which 
was undoubtedly due to the failure of sufficient skin 
action and consequent excessive kidney action. We 
have also found in giving adjustments, that the spines 
of patients in high altitudes were stiff and unflexible — 
much more so than the spines of patients in lower alti- 
tudes. This was evidently because of the tonicity, 
tension, and contractured condition of their spinal 
musculature. 

The bearing that these spinal contractions have upon 
the pathogenic processes, will be considered under the 
subject of Etiology. In this chapter our only considera- 
tion is that of spinal lesions from reflex contractions, and 
this, we believe, will present an entirely new thought to 
most practitioners of the healing art, and we hope that 
others may be induced to investigate more fully along 
this line, and will help to give to the world some new light 
concerning interference with nerve supply, its causes, and 
its relation to abnormal function and disease. 

We further trust that this thought will lead to a more 
persistent study and practice of methods of spinal treat- 
ment for the removal of interference with the normal 
nerve supply, and for the restoration of normal function 
and health. This can be most successfully accomplished 
by spinal treatment methods that cause a relaxation of 
the spinal musculature. We should be sufficiently broad- 
minded to make use of the thrust and any auxiliary 
method of spondylotherapy or other methods of treat- 
ment that may prove efficient and practicable. 



CHAPTER VIII. 
RESULTS OF SPINAL LESIONS. 

THE results of spinal lesions are an important con- 
sideration for us, as well as the cause of spinal 
lesions, for the reason that spinal lesions are the 
causes of interference with the spinal nerves and conse- 
quently the cause of the derangement of function, existing 
or manifest, in all forms of disease, both acute and chronic. 
When we have any contraction of the spinal muscula- 
ture, and consequent interference with impingement of 
the nerve sheath, we may have one or more of a number 
of different things interfered with. We enumerate below 
the principal tissues that may become interfered with, in 
the performance of their normal function, as a result of 
an impingement of the neural sheath which contains 
them, where it passes through its intervertebral foramen, 
that has been narrowed by a contraction of the muscula- 
ture of a segment of the spinal column. We enumerate 
what may be impinged as follows: 
I. Afferent nerves. 
II. Efferent nerves. 

III. Veins from cord. 

IV. Arteries to cord. 
V. Gray rami to cord. 

VI. Lymphatics to cord. 
VII. White rami to sympathetic. 
Many in the study of spinal lesions see or mention 
but one anatomical formation that can be interfered with 
by the narrowing of an intervertebral foramina, namely, 
the nerves, but from the above enumeration we see that 
a number of things are contained in the neural sheath, 
and that they may, therefore, become involved as the 
result of impingement of the nerve sheath. 

158 



Results of Spinal Lesions. 



159 




Illustration showing how the nerve sheaths make their exit from the 
spinal column, or the neural canal, and how they vary in size owing to 
variation in the size of the foramina, which is due to muscular contraction 
along the spinal column. (Courtesy O. W. Lindstrom.) 



160 Interference With Nerve Function. 

I. Afferent Nerves. — The afferent nerve fibers 
that are in the nerve trunk and passing through the 
foramen in the nerve sheath, as they pass from their 
peripheral termination to the reflex center in the spinal 
cord, may be interfered with by impingement of the nerve 
sheath, caused by a narrowing of the foramen. Inter- 
ference with these fibers will interfere with the condition 
of the afferent nerve impulses, and consequently with 
the reflex motor action that would be normally produced 
in the tissues supplied. 

II. Efferent Nerves. — Interference with the effer- 
ent nerve fibers will impede the transmission of centri- 
fugal impulses, and consequently with the work done in 
tissues supplied by their end organs. As a result, we 
have deranged function, which is disease. 

III. Veins from Cord. — Veins passing out through 
the foramen from a spinal segment in the nerve sheaths 
drain that segment of the spinal cord, and when they are 
interfered with by being occluded partially, or completely, 
we will have more or less congestion of the spinal segment 
which they should drain, and the unfavorable effects 
and the influence of the toxic elements of the venous 
constituents will cause a deranged condition of the func- 
tion of the spinal segment. This will alter all afferent 
impulses that are reflexed therein. 

IV. Arteries to Cord.— The arteries that pass into 
and supply a spinal segment through the foramina and 
contained in the nerve sheaths, will furnish nutrition to 
that spinal segment. Any occlusion or impingement of 
these vessels will cause an anaemic condition, and thus 
interfere with the function of the spinal segment or 
center by decreasing or destroying the excitability of 
that spinal center, and of the nerves coming from that 
segment of the spinal cord. This condition will destroy 
the continuity of the reflex path through the spinal 
center. 



Results of Spinal Lesions. 161 

V. Gray Rami to Cord. — The gray rami communi- 
cantes also pass to the spinal cord contained in the nerve 
sheath into the neural canal, in connection with the 
afferent and efferent nerve fibers, and they supply the 
relative spinal segment. The gray rami control the pro- 
cesses of metabolism in this spinal center and are essen- 
tial to its cellular integrity and functional activity. 

VI. Lymphatics to Cord. — The lymphatics that 
ramify and supply the spinal cord also pass in through 
the intervertebral foramina in the nerve sheaths to the 
segment they supply; consequently any impingement of 
the nerve sheaths will interfere with the lymphatic supply 
to the spinal segments and alter the emanation and 
transfer of all impulses. 

VII. White Rami to Sympathetic. — As the white 
rami communicantes are also contained in the nerve 
sheaths of the spinal nerves, they may be interfered with 
by impingement of the nerve sheaths, as they pass through 
the intervertebral foramina. Any interference with the 
white rami communicantes which communicate with the 
sympathetic ganglia, will deprive these ganglia of their 
normal physiological nerve impulse supply which is 
originated in the spinal cord or brain centers, and any 
interference with the transmission of the physiological 
impulse supply that is continually being received by 
the sympathetic system, will interfere with the integrity 
of its automatic action. 

From interference with the circulation alone, we may 
have functional derangement of the nerve supply from 
the segment of the spinal column, whose circulation is 
interfered with. A congested condition of this spinal 
segment will alter the reflex impulses as they are trans- 
ferred from the afferent to the motor efferent nerves, and 
will also alter the physiological impulses originating in 
the nerve centers, and as a result of this functional 



162 Interference With Nerve Function. 

derangement, we have disease and histological altera- 
tions. 

There is one favorable phase of this derangement of 
the circulation, and this is, if the circulation supplied to 
one segment of the spinal cord is interfered with we 
may have established, by means of capillary anastomosis, 
a compensatory circulation from adjacent segments of the 
spinal cord. For the above reasons, functional derange- 
ment, which is the result of interference with the arterial 
supply or the venous drainage of a spinal segment, may 
disappear as soon as the collateral circulation is developed 
by anastomotic branches. 

When we have nerve impingement, we will have 
another and entirely different condition of affairs. In 
the first place, nerves do not anastomose like blood 
vessels where one is cut; neighboring nerves do not 
enter into and supply the same zone. 

Any mechanical impingement of nerves excites pain. 
An impingement of sufficient amount to interfere much 
with the function of the nerve, will always be indicated 
by the excitation and existence of pain, except where 
impingement has continued for a sufficient length of time, 
and is of sufficient severity, to paralyze the nerve that is 
impinged. 

We are always able to determine as to whether func- 
tional derangement is the result of nerve impingement 
or is the result of interference with the circulation, by 
the presence or absence of pain. As a result of inter- 
ference with nerves, lymphatics, arteries and veins, we 
have derangement of function but the absence of any 
pain. In case of impingement of nerve we have not only 
the manifest derangement of function, but also the 
existence of pain, unless there is a condition of lack of 
excitability or paralysis of the nerve subjected to slight 
pressure or to mechanical interference. 



Results of Spinal Lesions. 163 

AUTOPROTECTION. 

Because of spinal lesions, we find a certain train of 
conditions engendered which constitutes the predisposing 
cause or condition permitting the invasion of acute 
disease, and causing functional derangement that leads 
to the development and a continuation of chronic disease. 
As a summary of the results engendered because of 
nerve interference, we enumerate the following: 
I. Autoprotection. 
II. Normal tonicity. 
III. Normal circulation. 
Lack of <^ IV. Normal metabolism. 
V. Normal recuperation. 
VI. Normal thermogenesis. 
VII. Histological conformation. 

I. Lack of Autoprotection. — Autoprotection means 
self-protection, and if we lack autoprotection, we are 
unprotected against the invasion of disease. 

If autoprotection is sufficient, we will be invulnerable 
to both contagious and infectious disease, although we 
may be exposed to them. 

If autoprotection is below par, then we will fall a 
victim to almost any infectious or contagious disease to 
which we may be exposed. Although our general health 
may be good, we may fall a victim to any contagious 
disease that may invade a local zone in our organism, 
where our autoprotection is deficient. Lack of auto- 
protection denotes a general lack of vital activity and 
vital cellular resistance, all of which is due to an inter- 
ference with nerve supply and functional activity. 

II. Lack of Normal Tonicity. — Tonicity depends 
entirely upon nerve supply and nerve function. Any 
interference whatever with the nerve function, because 
of interference with the nerve's excitability or conduc- 



164 Interference With Nerve Function. 

tivity, will lessen the tonicity of the tissues in the zone 
supplied. Any interference with nerves, either because 
of impingement, nutritive alteration, or mental impres- 
sion, will alter the functional action of the nerves, and 
alter the tonicity of the tissues supplied. 

The lack of tonicity of the musculature of the spine 
is a permitting cause of spinal settling. Spinal settling 
will cause a slight anaemia of the spinal cord, and an 
irritability, and all the untoward symptoms that arise 
from this condition will follow. 

III. Lack of Normal Metabolism. — Metabolism 
means the processes of nutrition and building up or con- 
structive changes of the cellular tissues of the body, and 
also the processes of elimination of the ashes of combus- 
tion, so to speak, or of the by-products of functional 
activity. 

Metabolism, like tonicity and autoprotection, depends 
wholly upon the integrity of the nerve supply and func- 
tion. If the nerve supply to any one portion of the body 
is cut off, as, for example, the one limb of a child, it will 
prevent the trophic phase of the metabolic processes, 
which will result in non-development. 

If, in later life, a person by some accident, or as a 
result of some spinal lesion, suffers interference with the 
nerve supply to the upper extremity, that extremity will 
waste away, due to the cessation of the normal trophic 
processes of metabolism. 

Internal secretions have an important influence upon 
the processes of metabolism, but the secretion of the 
glands giving off internal secretions which are thrown 
into the blood channels direct, is the result of nerve 
function, and especially of the physiological nerve 
impulses transmitted over the nerves to the internal 
secreting glands. 

Any interference with the nerve supply to any of the 
glands producing the internal secretion, will directly 



Results of Spinal Lesions. 165 

interfere with the processes of metabolism throughout 
the entire body. 

IV. Lack of Normal Circulation. — Lack of normal 
circulation is a direct result of an interference with the 
vasomotor influences of the nerve supply. Nerves con- 
trol the circulation in all parts of the organism through 
their influence upon the walls of the circulatory system. 

Nerve impulse controls the contractions of the heart, 
and also the dilatation and constriction of the arteries 
and the valves of the veins, as well as the muscular walls 
thereof. 

A lack of tonicity of any part of the circulatory appara- 
tus, more especially in the capillary portion, tends to 
induce a condition of stasis. A sluggish condition of the 
circulation in any zone invites the invasion and develop- 
ment of infectious disease. 

By spinal treatment we have a direct effect upon the 
vascular system. Varicose veins of the lower extremity, 
as well as dropsical conditions from a weak heart, are 
readily overcome by restoring the normal nerve supply 
and vascular tone to the lower extremities and to other 
portions of the human anatomy. 

V. Lack of Normal Recuperation. — Our recupera- 
tive power depends wholly upon the efficiency of the 
nerve supply. It is impossible to recover from disease 
or from operative procedures, unless we possess recupera- 
tive power. Normal recuperative power is necessary 
that recovery may occur in a normal manner from any 
pathological lesions. 

In order to have this, we must have normal circulation, 
normal tonicity, normal metabolism, and all other condi- 
tions engendered by normal nerve supply and normal 
nerve impulse. 

We have treated patients who had suffered with ulcers 
for years, and healing of them would take place in a 



166 Interference With Nerve Function. 

short time when interference with the nerve supply was 
removed by spinal adjustment. 

We are brought to the inevitable conclusion after 
watching the result of spinal adjustment, that the 
recuperative power and the power of restoration, are 
maintained by, and depend upon, the integrity of the 
nerve supply and nerve function. 

VI. Lack of Normal Thermogenesis. — Lack of 
normal thermogenesis is also the result of interference 
with the normal nerve impulse, normal vital processes, 
and normal metabolic processes, all of which are depend- 
ent upon nerve function. 

If the nerve supply to the arm is interfered with, that 
arm and hand will be cold, not so much because of the 
lack of circulation, but because of the lack of the vital 
processes that should be maintained in the arm and hand. 
The nerve supply and function, however, that will 
establish the normal vital processes and normal thermo- 
genesis, will establish and maintain the normal circulation. 

The loss of heat is all controlled by nerves. 

Our skin action is controlled by nerves. 

Perspiration is controlled by nerves. 

Metabolism is controlled by nerves. 

We conclude, therefore, that the process of both heat 
production and heat elimination is directly under the 
influence and control of the impulses of the nervous 
system. 

VII. Lack of Histological Conformation. — The 
cellular arrangement is another matter that depends 
wholly upon nerve action. The process of metabolism 
controlled by nerve supply, is responsible for the main- 
tenance of cellular structures in their perfect condition. 

Both the trophic function controlling the building up 
process, and the growth of the cells of the body, and also 
the eliminative processes, are under the control of the 
nerve fibers that control the cell growth and development. 



Results of Spinal Lesions. 167 

Any interference with the circulation will interfere 
with the nourishment, and consequently the trophic 
supply of the nerves and also with all cell growth and 
cell multiplication. 

Any interference with the eliminative processes will 
prevent the metabolic process of cleansing and prevention 
of degeneration of the cells. The perfect nerve supply, 
however, will prevent derangement of cellular structures, 
while a derangement of function will engender cellular 
derangement. 

In our study of the subject of nerve interference, we 
learn that the function of nerves may be altered in several 
ways: 

1. Excitability of nerves may be increased. 

2. Excitability of nerves may be depressed. 

3. Conductivity of nerves may be increased. 

4. Conductivity of nerves may be decreased. 

5. Reflex centers of nerves may be too excitable. 

6. Reflex centers of nerves may be benumbed. 

7. Efferent transmission of impulse may be altered. 
If the terminal end apparatus of afferent nerves are 

tender, or sore, or their excitability is increased, then will 
the ordinary stimulus produce more than an ordinary 
excitation and impulse. 

If the excitability of the nerves is depressed, the 
normal stimuli will not cause or incite the normal amount 
of impulse. 

The impulse excited, then, depends upon the state of 
the excitability of the nerve, and any deviation from the 
normal condition of excitability will cause a correspond- 
ing deviation in the quantity or magnitude of the impulse 
excited by the stimulus. 

If the conductivity of an afferent nerve is increased, 
the impulse may be increased while being transmitted. 

If the conductivity of an afferent nerve is depressed, 



168 Interference With Nerve Function. 

then the impulse may be diminished during the trans- 
mission to the reflex center or brain. 

Any alteration of the conductivity of an afferent 
nerve will alter impulses that are transmitted according 
to the derangement of the conductivity. 

The condition of the reflex centers in the spinal cord 
or in the brain, may be altered because of anaemia or 
because of any other pathological condition. In such 
case we do not have the normal generation nor emanation 
of the physiological impulses from the nerve centers. 

The impulse that is received as the result of a stimu- 
lation of afferent nerves and carried to the reflex centers 
of the cord, are not transferred perfectly by the reflex 
centers which are depressed; or, they are magnified if 
the reflex center is in an excitable condition. The per- 
centage of loss or of gain in the reflex center is propor- 
tionate to the pathological derangement of the functional 
action of the reflex centers. 

Suppose there is a stimulation of an afferent nerve. 
Now, if the excitability is normal, a normal impulse will 
be generated, but if the excitability varies from the 
normal, there will be a like variation of the volume of 
the impulse that is engendered because of the stimulation. 

Suppose that only half of the normal impulse is 
generated from a stimulus because of the lack of excit- 
ability of the end apparatus of the afferent nerve, we can 
then have but half of the normal impulse for transmission 
to the reflex center which is in the gray matter of the 
spinal cord, and although the reflex act and conductivity is 
normal, we have but fifty per cent of a return impulse 
for transmission over the efferent route. 

If the excitability of the afferent nerve is normal, 
then the impulse engendered by stimulation will be 
normal also, provided it is not altered in afferent trans- 
mission or in the reflex centers. 



Results of Spinal Lesions. 169 

If the efferent nerve is in any way interfered with 
the impulse may be altered, either increased or diminished 
during the efferent transmission in proportion to the 
alteration of the function of the efferent nerve. 



CHAPTER IX. 
ETIOLOGY. 

ETIOLOGY is a treatise of the cause of disease. 
We are interested in the subject of etiology in 
this connection for several reasons: 

One of the more important reasons is that up to the 
present time there are many questions unanswered as to 
the cause of disease, in ordinary works written on the 
subject of etiology. 

We cannot obtain from our medical literature an 
explanation of why one person will suffer with chronic 
asthma while another does not. 

Why one person is afflicted with hay fever, and why 
others are not. 

Why one person suffers with chronic rheumatism and 
why others do not. 

Why, in many cases, some will suffer with indigestion 
or some of the different forms of dyspepsia, while others 
are not troubled in this way. 

In fact, a great many questions like this, as to the 
etiology of chronic disease, are as yet practically unan- 
swered by practitioners of the orthodox schools of medicine. 

Some advancement has been claimed by recent writers 
who have studied the question of autoprotection, as to 
a knowledge of the etiology factors, but no satisfactory 
means have been discovered for production of the functional 
efficiency of cellular tissues or agents that will enhance the 
necessary autoprotection sufficient to prevent the inva- 
sion and existence of acute and chronic disease. 

We may consistently ask the question why one person 
will take typhoid fever while another does not; why 
part of a family of brothers and sisters, while living under 
the same conditions and eating of the same diet, and 

170 



Etiology. Ill 

consequently suffering the same exposure to infection, will 
succumb to typhoid while other members of the family 
do not. 

We might roughly say that the reason why the above 
is true, is because the autoprotection is sufficient in one 
case to prevent the invasion of disease, while in the other 
case there is a lack of sufficient autoprotection, which 
rendered the zone of predilection of the typhoid bacilli 
vulnerable to their invasion and development of this 
disease. 

We should go still further in our answer to this ques- 
tion, and state why the autoprotection is low in the 
one person, permitting the invasion and development of 
disease, while it is efficient in other cases, preventing the 
invasion or development of the typhoid bacilli and the 
consequent development of disease. 

The same question may be asked concerning why 
some children are victims of different contagious diseases, 
and others, under like conditions and enjoying apparently 
the same health, go free. 

Again, the question arises: Why some children, who 
are enjoying apparently perfect health, will fall victims 
to a certain infectious disease, while others enjoying a 
less perfect condition of general health, will go free. 

All the above questions we believe can be satisfactorily 
answered, and we hope that the reader of this work will 
be intelligently satisfied in his own mind as to the answer 
to the above questions, after he has studied this work 
chapter after chapter. 

We are aware that a great advancement has been 
made in the study of pathology and in the study of 
pathological agencies during the past few years since the 
invention of the microscope. The painstaking study and 
experiments of our eminent pathologists have given us 
great light on many subjects. By means of the micro- 
scope we have learned of the existence of germs. In our 



172 Interference With Nerve Function. 

pathological laboratories we have studied and demon- 
strated that they are important etiological factors in the 
production of all infectious and contagious diseases. As 
a basis for our study of the subject of etiology, we accept 
the ordinary classification, namely: 

1. Exciting causes. 

2. Predisposing causes. 

Exciting Causes. — We will consider for a moment 
some of the more important classes of exciting causes of 
disease, and begin our consideration by making an enumer- 
ation of the principal exciting causes under the following: 
I. Exposure. 
II. Infection. 

III. Traumatism. 

IV. Errors of diet. 

V. Errors of exercise. 
VI. Poisonous medicines. 
VII. Poisonous food stuffs. 

Under the headings above we have enumerated what 
we believe to be the principal exciting causes of disease. 

I. Exposure. — It is a well-known fact to any intelli- 
gent person who has given the matter any thought, that 
exposure to cold or to extreme heat or exposure to damp- 
ness and moisture, will induce colds, and, as a result 
of failure of elimination, sometimes rheumatic affections 
and pneumonia. Many a person has lost health from 
exposure, many can attest the truthfulness of the state- 
ment that exposure is a direct cause of pathological 
conditions of disease. 

There is no doubt that some may be subjected to 
more exposure than others without being apparently 
affected thereby. The general condition of the patient 
may be sufficient in some cases to withstand consider- 
able exposure of different kinds, while with others the 
conditions are such that much less exposure will induce 
different pathological conditions. It is an evident fact, 



Etiology. 173 

however, that exposure is an exciting and direct cause of 
much disease, hence we pass this subject without further 
comment. 

II. Infection. — When the microscope first revealed 
the existence of germ life, and when infection first began 
to be understood by the scientific students of our day, 
to be etiological agents, there were a number of M. D.'s 
that scoffed at the idea. When the claim was set forth 
that these infections were the cause of infectious and 
contagious disease, it was disbelieved by all of the less 
informed, and especially those who had never had the 
privilege of looking at the prepared specimens of bacteria 
through a microscope. 

As the years rolled by, and as more light has been 
thrown on the subject of etiology, by investigation of 
the subject of infection and its connection with disease 
as an etiological factor, practically all of the medical 
profession, because of further investigation, have finally 
accepted the truthfulness of the theory that infection is 
an exciting cause of disease. 

We are surprised that some are still in the dark in a 
great measure. Among those denying that germs are 
etiological factors are recent self-styled discoverers and 
developers, who claim that germs have nothing to do 
with the production of disease. 

Every intelligent person knows that it would be 
impossible to catch mumps if one were not exposed to 
them. It is also absolutely impossible to catch measles, 
whooping cough, scarlet fever, diphtheria, smallpox, or 
any other of the contagious diseases, without being in 
some way exposed to the infection or the bacteria 
that is the direct and absolute cause of them. 

The relation of bacteria to the etiology of disease has 
been studied in a very careful way. Before a specific 
germ has been recognized as the cause of a specific 
disease, it must comply with four laws. In studying the 



174 Interference With Nerve Function. 

germ that is the cause of any special disease, its behavior 
must conform to the following: 

1. The specific germ is always present. 

2. This germ must be grown in a pure culture. 

3. The cultured germ must produce the same disease. 

4. This specific germ must be found in the produced 

disease. 

Now if the specific germ conforms to these four laws, 
it is considered proof that this germ is the exciting cause 
of the disease in question. One law of germ fife is that 
they do not originate de novo. For this reason contagious 
diseases are not and cannot originate except from exposure, 
directly or indirectly, to that specific infection. Take 
the following example: 

Suppose that twenty children visit a Sunday school 
and one of their number is breaking out with measles. 
A number of the children present will become inoculated, 
and after a period of incubation they will suffer an 
invasion or attack of measles. 

Suppose at another point twenty children gather at 
school but none of them have measles, then we would 
know that none of these children would take measles. 
For a child to become infected, exposure to an infection 
is necessary, hence the infection is the exciting cause. 

Now, on the theory that nerve pressure is the cause 
of all disease, as is claimed by late philosophers, (?) we 
would be led to the conclusion that the first group of 
children had nerve pressure, while the last group did not. 

We know that sometimes a person may be exposed 
to a contagious disease and not take it, but that does 
not prove that the infection to which he was exposed 
will not produce and cause that specific disease, if the 
conditions in the patient are favorable, because of the 
lack of autoprotection. 

It is autoprotection, or the lack of autoprotection, 
that accounts for the difference, and explains why one 



Etiology. 175 

will, and one will not, become infected with any conta- 
gious disease to which they may be exposed. 

It may not be apparent to some how we may be able 
to affect, by spinal treatment, diseases that are caused 
by an infection. In this connection, we call attention to 
the fact that the invasion of disease is permitted by or 
is due to the lack of autoprotection. Lack of autopro- 
tection is due to interference with the function of nerves. 
If we remove all interference with the nerve supply to 
the zone of the infection, and in so doing stimulate that 
nerve supply, we will establish that autoprotection that 
will prevent the further development of the infection, and 
a return to the normal will follow. 

Should we, on the other hand, try to destroy the 
infection by the administration of drugs, we will find it 
impossible to administer medicine that is sufficiently 
toxic to act as a bactericide without poisoning and 
destroying the patient. 

III. Traumatism. — The word traumatism refers to 
wounds, and may refer to wounds of any nature, as cuts, 
bruises, fractures, dislocations, etc. When cellular tissues 
are deranged or altered their normal nerve supply cannot 
produce normal function therein. The cutting or bruis- 
ing of a nerve will destroy its action and alter the function 
produced by the nerve. 

Many traumatic wounds are very severe, causing 
instant death. As a result of bruises, some people will 
have boils, carbuncles, etc. Traumatic wounds are 
evidently not the result of nerve impingement but of 
accident. 

IV. Errors of Diet. — Probably one of the most 
common causes of derangement and disease, is error of 
diet. 

(1) One of the most common errors of diet is prob- 
ably excessive eating. 



176 Interference With Nerve Function. 

(2) Another very common dietetic error is eating at 
railroad speed. 

(3) Another dietetic error is eating wrong food 
combinations. 

(4) Still another dietetic error is eating foods con- 
taining toxins as a result of decomposition. 

There is no doubt we have some nerve interference 
in certain regions of the spinal column in connection 
with all disease. In the case of digestive derangement 
there is no doubt but what we have some impingement 
of nerves that supply the alimentary tract, especially 
the gastric region, but in this connection, allow me to say 
that nerve pressure is not the primary cause of any disease. 
Nerve pressure is always the result of exciting causes. 

We do not believe it necessary to make any further 
remarks on the subject of dietetic errors being the cause 
of disease, as we feel it is a recognized etiological factor 
by all intelligent and thinking people. 

V. Errors of Exercise. — An error in the amount of 
exercise that is regularly taken is another cause of disease. 
Excessive exercise may engender untoward effects in 
different ways: 

First, the athlete is prone to suffer hypertrophy of 
the heart as the result of over-exertion. Excessive exhaus- 
tion from overwork produces muscle tire; consequently 
general hypo-tonicity of the musculature of the spine, 
which leads to undue settling. 

Over-exercise, however, is not the cause of as much 
trouble as is insufficient physical exercise. Some of the 
most stubborn cases, and some that we could not get 
results with by treatment, were those that would give up 
and lie in bed. A well person who will lie in bed contin- 
ually, will lose his strength and so be brought to death's 
door. We have known of people lying in bed and eating 
three meals a day, having their meals brought to them 
because they felt dizzy when getting up to walk. 



Etiology. 177 

We cannot regain nor maintain any muscular strength 
while continuing in a state of inactivity. An athlete 
preparing for a contest would never expect to gain strength 
by lying still. The internal organs become sluggish; the 
vascular system becomes weak, and a general retrograde 
series of changes takes place in the person who allows 
himself to remain in bed, and dissolution is the inevitable 
result. People of sedentary habits are prone to become 
neurasthenics, dyspeptics, and to suffer with insomnia. 

VI. Poisonous Medicines. — That the use of strong 
medicines is detrimental in many cases and will do harm, 
is the firm belief of the author, and it is also the belief 
of many learned physicians. In fact, our best physicians 
do not wish to take their own medicines, nor want their 
families to swallow much of the stuff that is given out 
from our apothecary shops. 

"It is my firm belief that the prevailing mode of 
practice is productive of vastly more evil than good, and 
were it absolutely abolished, mankind would be infinitely 
the gainer." — Dr. Cogswell, Boston, Mass. 

This statement from an eminent authority is worthy 
of consideration. Many other eminent physicians have 
made similar statements concerning the modern use of 
drugs. Prof. Jamison, of Edinburgh, says: "Nine times 
out of ten our miscalled remedies are absolutely injurious 
to our patients." 

We are sure that there is truth in these statements and 
we want to enlighten the people who read this article as 
to some ways in which drugs produce injurious results 
when taken at the suggestion of a member of the laity 
and as per the routine dosage of regular medical 
practitioners. 

It is an undisputed fact that the constant use of 
cathartic medicines will sooner or later cause a persistent 
chronic constipation. We are confident that nine tenths 
of all cases of chronic constipation may be traced back 



178 Interference With Nerve Function. 

to the habit of taking pills or some other cathartic or 
laxative, as is the habit of many people who are educated 
to do so by their parents or by the medical practitioner. 
A person is many times worse off after becoming a pill 
fiend, or after taking cathartics, than if he had never 
fostered such habits and induced conditions which will 
always result. 

Morphine is often taken for the relief of pain, until 
that baneful habit of morphinism is engendered. But 
while taking' morphine for the pain, we are increasing the 
excitability of nerves to the sensibility of pain, and thus 
producing a condition of our nervous system a thousand 
times worse than if we had never used that harmful drug. 

Morphine to-day is known to be one of our greatest 
curses because of its baneful effect. This morphine habit 
is worse than drunkenness. It is an accursed habit — a 
vice that soon becomes a nervous disease, destroying the 
equilibrium of the mind, and destroying the will power 
and moral character of the patient. 

Unfortunately the making of morphine victims goes 
on steadily, and the doctors are originally responsible for 
nine out of ten of these drug victims. 

Strychnine is to-day the Samson of materia medica, 
and is given almost for everything. It greatly stimulates 
all the functions of the body because of its general effect 
upon the entire nervous system. Strychnine has a direct 
action upon the tendons and other tissues of the spinal 
column, causing their contraction, and producing a con- 
tractured condition of the spinal column, which is incom- 
patible with good health. 

An overdose of strychnine produces fatal results or 
death, by the extreme contraction of the tissues of the 
spinal column, causing a drawing backward of the 
head and lower extremities, and an arching forward of 
the vertebral column into a condition of opisthotonos. 
When the spine is bent forward in this manner, it 



Etiology. 179 

narrows the intervertebral foramina, impinges the nerve 
sheaths, and cuts off the nerve supply to the lungs, heart 
and all vital organs, and thus produces death. 

In lighter doses we have the same effects produced in 
a less degree. A slight narrowing of the spinal foramina 
excites the spinal centers, the action of them is increased 
at the expense of their freedom and normal condition. 
The stimulating or exciting effects of strychnine, which 
are caused by slight interference with nerves because of 
a slight narrowing of spinal foramina, will, as a secondary 
result, impair the action of nerves in proportion to the 
amount of interference. Strychnine will leave its mark 
on the spine which is manifest in the condition of its 
musculature. 

Digitalis is a commonly used remedy in functional 
heart troubles. It is often accumulative in its effects, 
and produces harmful, and sometimes fatal results. 
Decided cheynestroke respiration is a common result of 
the use of digitalis. 

We feel confident that the most healthful person who 
may habitually use strychnine or digitalis will sooner or 
later die of heart disease. 

The constant use of medicines that stimulate and 
irritate the kidneys will induce derangement of these 
organs, and if the kidney remedies are persisted in, they 
will ultimately cause death from kidney disease. 

Many, many cases of stomach trouble are directly due 
to the use of strong medicine, and many cases will improve 
when the use of drugs is discontinued. 

Many patients have told me that they had quit the 
habit of taking drugs, and that they were enjoying an 
improved condition of health since doing so. Ask any 
well-informed and honest M. D. as to the correctness of 
the above, and he will tell you 'tis too true. 

So, in conclusion, we will give the following recipes 
for the production of diseases: 



180 Interference With Nerve Function. 

1. Hypnotics, to produce insomnia. 

2. Cathartics, to produce constipation. 

3. Digitalis, to produce heart trouble. 

4. Morphine, to produce sensitiveness to pain. 

5. Kidney medicine, to produce kidney disease. 

6. Strong medicine, to produce stomach trouble. 

7. Headache powders, to produce the headache habit. 

VII. Poisonous Food Stuffs. — We may have poison- 
ous food stuffs resulting from decomposition, and we may 
use narcotics and alcoholic drinks which will become, by 
their use, etiological factors. 

Persons sometimes, after eating canned fruits, are 
poisoned thereby. We may eat flesh containing animal 
parasites, especially the tapeworm and the trichina. It 
is estimated that practically one out of every fourteen 
hogs is infected with trichina. For this reason American 
pork is excluded from some of the European countries. 

The habitual use of beer lowers autoprotection, and 
also decreases the power of recuperation. When beer 
drinkers are overtaken by a contagious disease, by 
pneumonia, or by any other disease, they more readily 
succumb than those who abstain. Alcoholic drinks will 
also cause disease of the liver, stomach, and kidneys. 

In the case of food containing poison, or containing 
animal parasites, or in the use of tobacco or alcoholic 
drinks, we cannot possibly lay the disease engendered at 
the door of nerve impingement as the cause. On the 
other hand, the nerve impingement that exists in such 
cases, or, more correctly speaking, the nerve interference, 
is not the cause, but the result of the use of these detri- 
mental and poisonous food stuffs, and the reason of the 
involvement of the spine in such cases is explained in 
previous chapters. 



CHAPTER X. 

ETIOLOGY— Continued. 

PREDISPOSING CAUSES OF DISEASE. 

A PREDISPOSING cause, strictly speaking, is a 
permitting or vulnerable condition existing within 
the animal organism. 

The term autoprotection means a vital condition that 
enables the tissues to resist the invasion of disease, while 
lack of autoprotection would be synonymous in meaning 
with the term predisposing cause, and refers to that lack 
of vital resistance which will permit the invasion and 
development of the bacteria of infectious and contagious 
diseases. 

The nervous system is the agency of the production 
of all function within the body; therefore all vital resist- 
ance, autoprotection, or lack thereof, is directly due to 
the condition of the nerve supply and nerve function. 

The predisposing cause is necessarily present, that 
the exciting cause may be enabled to invade and develop 
pathological processes. For this reason the predisposing 
cause, or lack of autoprotection, is a most important 
subject of consideration from a prophylactic standpoint. 

Any condition or agency that removes the predispos- 
ing cause of disease or that establishes normal auto- 
protection, becomes at once the most important factor 
and consideration in the prevention of disease, while any 
agency that will produce the opposite condition is directly 
responsible for the inroads and development of infectious 
and contagious disease. 

The predisposing cause is responsible for the derange- 
ment of function, or lack of vital function, which exists 
in all chronic forms of disease, and is also the cause of the 

continuation of chronic disease. 

181 



182 Interference With Nerve Function. 

Predisposing cause is not a primary cause but is a 
secondary cause, being the result of agencies or influences 
that interfere with the nerve supply and nerve function 
that is necessary for the production of normal vital 
resistance. Nerves are responsible for the performance 
of all function, and it is interference with nerve supply 
that causes derangement of function, and it is ordinary 
spinal lesions that usually and primarily cause nerve 
interference; therefore we are carried back in our study 
of etiology to those agencies that result in spinal lesions 
and spinal interference with normal nerve supply. 

For example: Let us study briefly the etiology of 
typhoid fever. That we may comprehend more fully the 
principles laid down in this chapter, we consider the ordi- 
nary infectious disease of typhoid fever. 

The question might be asked, as above, why in a 
family of several members, part will succumb to an 
invasion of typhoid, while others go free. Now the 
answer that we would ordinarily make to this is that the 
vulnerable condition of the alimentary tract is the per- 
mitting cause of invasion in the ones who succumb to 
this disease, and a sufficient amount of autoprotection is 
the protective agency in case of those who did not become 
infected with typhoid. 

Now the responsible agency in the production of the 
normal autoprotection that caused part of that family 
to escape typhoid fever, is due to a normal nerve supply 
and a normal supply of the physiological impulses or life 
force conveyed to the part by the efferent motor nerves 
and normal vital cellular activity and resistance. 

It is very evident that lack of autoprotection in those 
who succumb to this disease, is directly due to some 
interference with the normal functioning and cellular 
activity or vital resistance of the zone that becomes 
infected, and this condition is due directly to some inter- 
ference, that is cutting off the normal impulses which 



Etiology — Predisposing Causes of Disease. 183 

would produce the normal autoprotection and prevent 
the invasion of the disease. Therefore, the consequent 
lack of autoprotection, or predisposing cause, is that 
favorable condition to the invasion and development of 
the bacteria exciting pathological processes which engen- 
ders the toxins that excite the fever. 

Persons in general health may be in apparent good 
condition, and yet vital resistance or autoprotection in 
the small intestines where the typhoid germ invades, 
may be below par, and notwithstanding the apparent 
good health of the patient, he may fall a victim to the 
invasion of the typhoid bacilli, and a consequent victim 
to typhoid fever. 

On the other hand, a person who is not apparently in 
robust health may have sufficient autoprotection in the 
alimentary tract to resist the invasion and development 
of the typhoid bacilli, and this person may go free. It 
is the autoprotection in the local zone of predilection of 
the typhoid bacilli that is necessary to prevent the 
invasion of this disease. 

This is also true of all infectious and contagious 
diseases. The autoprotection that resists the invasion of 
disease is not dependent so much upon the general 
condition of the system, as it is upon the condition in 
the special zone of predilection of the specific infection. 

The conditions and reasons for invasion of typhoid 
fever as given above, are similar to those existing and 
permitting the invasion of any of the infectious and 
contagious diseases. Any agency or any condition lower- 
ing the general vitality, or lowering the autoprotection 
of any specific zone, will induce that predisposing cause 
of disease, or a lack of autoprotection. 

Any of the nerve depressants will induce the pre- 
disposing cause of disease, or cause the lack of normal 
autoprotection. Any of the exciting causes of disease 
will affect the condition of the musculature of the spine, 



184 Interference With Nerve Function. 

and consequently cause interference with nerve function, 
and in doing this, they engender the lack of autoprotec- 
tion. Autoprotection means health, while the lack of 
normal autoprotection permits the possibility of the 
invasion of disease. 



PAIN 

/ T V HE subject of pain has been much discussed. We 
-■■ feel that new ideas concerning the cause and the 
best method of relieving pain, and other phases of this 
subject, justify a little space given to this subject in this 
connection. 

There are five questions we may answer about pain: 

1. Definition. 

2. Where excited. 

3. Where produced. 

4. Where referred. 

5. Where it exists. 

Definition. — Pain is the cry of an injured nerve. 

Pain may be defined as an interpretation, made by 
the brain, of an afferent impulse which is produced by an 
irritation or an injury of a nerve trunk or afferent nerve 
fibers. Any spinal lesion that causes nerve interference 
does so by an encroachment upon the integrity of the 
nerve sheath, where it extends from the neural canal 
through the intervertebral foramen. 

As stated above, this interference may cause either 
vascular occlusion or nerve impingement. It is in the 
case of the more extreme contraction of the musculature 
of the spine that the nerve becomes impinged. This is 
due to the fact that the nerve is more resistant and main- 
tains room for itself at the expense of the veins, arteries 
or lymphatics. If, however, the narrowing of a foramen 
is of such an extent as to impinge the nerve, we will then 
have the sensation of pain. 



Etiology — Predisposing Causes of Disease. 185 

Now pain might be defined as being the cry of an 
injured nerve, and in this definition we differ from our 
former teaching, in which we were told that pain was the 
cry of a hungry nerve. 

The author has fasted seven days and has had the 
watch care of a patient who fasted seventy days, and 
others who fasted thirty to forty days, and in no case 
has there been any pain present after the first few days 
of the fast. The experience we have had with fasting 
proves conclusively to our minds that pain is not the 
cry of a hungry nerve. On the other hand, we are as 
firmly convinced that we are correct in our new definition 
of pain, namely: That pain is the cry of an injured 
nerve or that pain is an interpretation of an afferent 
impulse from nerve irritation or traumatism. 

II. Where Excited. — Pain may be excited any- 
where a nerve is injured. A nerve fiber is often irritated 
and excited from traumatic agencies affecting the end 
apparatus of the afferent or sensory nerves. 

In the human organism the great majority of pain is 
not excited by peripheral irritation or by traumatic 
irritation of afferent nerves, affecting their end apparatus, 
but the majority of pain is produced by reflex contrac- 
tion and impingement of the nerves where they pass from 
the spinal column through the intervertebral foramina. 
We can readily see how this may be true, when we con- 
sider the mechanical properties of nerve fiber. 

Nerve fiber is tough, tenacious, unelastic, — more 
so than any other tissue of the body except osseous 
tissue. No place in the course of nerves, either afferent 
or efferent, are they surrounded by movable bone, except 
where they make their exit from the neural canal between 
the pedicles of adjacent vertebrae. 

Contraction of muscular tissue anywhere else in the 
body will have little or no effect upon the nerves, for the 
reason that they are more resistant than muscular tissue, 



186 Interference With Nerve Function. 

and therefore the nerves will take care of themselves, 
except in the end apparatus of the afferent nerves. In 
this case swellings and cell proliferation may become a 
local excitant of pain due to mechanical injury to the 
delicate sensitive end apparatus of the afferent nerves. 

A contraction, or contractured condition of the muscu- 
lature of the spine that approximates vertebrae and 
narrows the intervertebral foramina between their pedi- 
cles, will bring osseous tissue to press upon and impinge 
the nerve sheath and for this reason pain may be, and is, 
produced in most cases by nerve impingement between 
pedicles of vertebrae. 

The proof of this fact is, that in almost all cases of pain 
we may give almost instant relief by a specific thrust to 
overcome the contractured conditions of the musculature 
of the spine, and especially those tissues, as muscles, 
tendons or ligaments, which are directly responsible for 
the approximation of the vertebrae and impingement of 
the nerve supplying the painful zone. 

In cases in which the pain is chronic and unyielding 
to ordinary treatments, in the head regions, we have, by 
giving a thrust and relieving the cervical nerves that 
join the cranial nerves by means of communicating 
branches, been enabled to relieve the pain as in tooth- 
ache, tic douloureux, etc. 

The pain of appendicitis, intercostal pains, gastralgia, 
pleurisy, and other pains in the internal viscera, yield 
very quickly to thrusts that are given for the purpose of 
relieving the spinal impingement affecting the nerve 
supply to the painful organ. 

III. Where Produced. — In the above remarks we 
have practically covered the ground as to where pain is 
produced, and a great majority of all pain is produced 
by spinal lesions, as indicated above, while the exciting 
factor of the pain acts in all cases almost wholly upon 
the peripheral apparatus of the afferent nerve. 



Etiology — Predisposing Causes of Disease. 187 

In the case of a finger burn, the pain, except that which 
is instantaneously produced by the injury to the peri- 
pheral apparatus of the afferent nerves, is produced at the 
spinal exit of the nerve supply to the burned finger. While 
the finger is burned, the afferent excitation travels via 
the sensory nerve to the spinal center. It is then trans- 
ferred, and travels over the entire route of the motor 
nerve. 

The first branch of the motor nerve that becomes 
excited and produces action by means of the end organs 
in the tissues supplied, is the primary posterior division 
of the nerve. This nerve is distributed to and causes a 
contraction of the musculature of the spine. The spine 
then is contracted before the centrifugal impulse passing 
over the efferent nerve reaches the finger that is burned, 
and no doubt the pain, more especially that which con- 
tinues after the burn, is due to the spinal contraction 
and consequent nerve impingement. 

Where Referred. — Pain is referred in all cases to 
the peripheral end of the afferent nerve, notwithstanding 
the fact that it may be produced at the spinal exit of 
the nerves. This fact of the pain being referred to the 
afferent nerve ends is, in most cases, as it should be. 
This fact always enables a person to know the point of 
irritation, and this assists us in our protective measures 
against injury. 

One noted exception to this rule is in the case of reflex 
pain. Reflex pain produces many rather complicated 
phenomena. 

There are some phenomena of referred pain that 
demonstrate the truthfulness of the statement that pain 
is referred to the peripheral portion of the afferent nerve 
endings. 

A person who has lost a limb will complain of cold 
feet; a person who has no hands will complain of his 
fingers getting cold. In this case we evidently have the 



188 Interference With Nerve Function. 

pain referred to the location of the former or original 
endings of the afferent nerves. Now, as nerves are pre- 
pared for the reception of an impulse at their peripheral 
endings, it would seem that the cut end of afferent nerves 
would not receive sensation. Perhaps, though, as time 
goes by, the nerves will form new peripheral end appara- 
tus, and in this way sensations are received, but the 
brain continues to refer them back to the point of the 
original peripheral endings of the afferent nerve. 

Where It Exists. — Pain exists in the brain. 

As a further definition of pain, we repeat partly the 
definition given above. Pain is an interpretation in the 
brain of an injury to a nerve. The interpretation of pain 
is made in the brain; consequently pain exists only in 
the brain. This may not seem plausible to the reader at 
first. 

If the sensory nerves that lead from the cut, burn, 
wound, injury, or irritation of any kind, are paralyzed, 
so they cannot be excited, or if they are so impinged 
that they cannot transmit the impulse, you will feel no 
pain. 

If anything interferes with the conductivity of the 
nerve or its excitability, the sensation of pain will be 
decreased thereby in proportion to the amount of inter- 
ference with the conductivity or excitability. 

On the other hand, if a nerve is irritable, excitable or 
tender, the impulse excited will be excessive and the pain 
increased in proportion to the increase of excitability of 
the nerve. 

In anaesthesia the conductivity of nerves is destroyed. 
The excitability is also destroyed, consequently the sensi- 
bility, and the patient will feel no pain when under com- 
plete anaesthesia. 

If a limb is paralyzed, you cannot feel pain, although 
traumatic injury is done to the limb. This is because 
there is no excitability of the afferent nerves and no 



Etiology — Predisposing Causes of Disease. 189 

conduction of the centripetal impulse to the brain. For 
this reason no interpretation is made and no pain exists. 
If the nerve supplying any zone in the body is severed, 
that zone has no sensation, and injury to that part 
excites no pain. If the nerve supply to the fingers is cut 
off, the fingers may be amputated without pain. If the 
spinal centers are benumbed by an injection into the 
spinal column, operations in the region supplied by the 
nerves from the segments, so anaesthetized, will excite no 
pain. 

Pain is an interpretation by the brain of an irritation 
or an injury to an afferent nerve ending; hence it is 
unavoidable that pain exists truly and only in the brain. 
If the mind is intensely engaged, a person may feel no 
pain from a cut or injury. The attention of the brain 
must be drawn to the excitation; otherwise no interpre- 
tation is made and no pain exists. In a fight a person 
may be wounded without any knowledge or sensation 
of it. 

. On the other hand, a patient who expects and is 
dreading to feel a pain, as they do when they go to a 
dentist, the pain will be greatly increased by the anticipa- 
tion which causes an instant reception and interpretation 
of the afferent impulse. 

The peripheral end apparati of afferent nerves are 
especially prepared for the reception of impulses from 
irritation, consequently more pain is felt from lesions to 
the periphery of the body than is felt by traumatic inci- 
sion of the deeper tissues. Surgeons will elicit more 
pain by making superficial incisions of the skin than 
they will when they sever the deeper tissues, which is 
due to the greater abundance of the afferent nerve endings 
in the peripheral tissues. As a summary, then, we enu- 
merate the following: 

1. Pain is the cry of an injured nerve. 



190 Interference With Nerve Function. 

2. Pain is an interpretation made by the brain of 

an injury to an afferent nerve. 

3. Pain is excited by irritation or injury of the 

peripheral afferent nerve endings. 

4. Pain is produced by the impingement of nerves 

at their point of exit from the neural canal 
through the intervertebral foramina. 

5. Pain is referred to the point of the original 

p eripheral endings of the afferent nerves that 
are injured or irritated. 

6. Pain being an interpretation of an injury to 

peripheral afferent nerve endings that are 
made by the brain, therefore it really exists 
within the brain. 

7. Pain indicates that the nerve is alive and it does 

not need to be deadened by an anodyne, but 
should be relieved from the mechanical im- 
pingement or irritation that causes the pain. 
To deaden a nerve that expresses a pain is like killing 
a boy who reports to you that your house is on fire. 



CHAPTER XI. 

ETIOLOGY— Continued. 

FEVER. 

THE etiological factor in the production of fever is 
worthy of some consideration, and a knowledge of 
this subject is often helpful in diagnosis. In the 
works we have read we have not seen advanced any infor- 
mation on the subject of fever that gave a correct state- 
ment as to the cause of its production. 

Fever is rather a symptom of a disease than a disease. 
Its chief characteristic is that of an elevation of the 
temperature accompanied by certain other symptoms, 
such as acceleration of the pulse, and quickened respira- 
tion. 

The temperature is maintained uniformly at about 
98.6 degrees in the human organism. At all times we 
have the process of heat elimination and heat production, 
going on within the body. When the relative rate of 
heat loss and heat production remains normal, we have 
the maintenance of the normal temperature. If there is 
any lack of this equilibrium between heat loss and heat 
production, we will have an alteration of the temperature 
from the normal. 

In fever we have a derangement of the normal relation 
between heat production and heat elimination. The 
nature of the derangement is that heat production is 
increased, while the heat loss is not increased, or not 
increased to as great an extent relatively as the heat 
production is increased. 

Heat production is due to an excitation of the nervous 
system, especially that function of the nervous phenom- 
ena that controls the production of heat. The thermo- 

191 



192 Interference With Nerve Function. 

genetic centers in the brain are excited and overactive 
and responsible for the increase in heat production. 

In order to have the excitation and impulse produced 
which excites heat generation, we must have some nerve 
stimulus present and acting upon either the nerve centers 
directly through the circulation or renexly through 
excitation of the peripheral endings of sensory nerves. 
Fever is a very common ailment, and for that reason the 
cause thereof is worthy of our attention. 

Cause of Fever. — From a very careful study of the 
etiological factor causing fever and of the phenomenon 
thereof, the author has arrived at the conclusion that the 
increased heat production causing a rise of temperature 
is due to an overexcitability and undue stimulation of 
the nerves or thermogenetic centers which is caused by 
the action of toxins upon the nervous system. In short, 
fever is the result of toxemia. 

Sources of Toxins. — Toxins affecting an excitation 
of the nervous system, especially of the thermogenetic 
centers and the action thereof, are as follows: 

1. Toxic retention. 

2. Bacterial toxins. 

3. Autointoxication. 

The fact that toxins which are retained in the body, 
through failure of elimination, will produce a sudden and 
abrupt rise of temperature, is evident for several reasons: 

By toxic retention we refer especially to the retention 
caused by a failure of skin action or skin elimination. If 
the skin is varnished, we have a sudden rise of tem- 
perature, and fatal results following very quickly. The 
retention of the elimination which should go on through 
the skin will accumulate in a very short time in sufficient 
quantities to have a decided effect upon the thermo- 
genetic centers and cause elevation of temperature. 

In case of sunstroke, the skin will cease to act. As a 



Etiology — Fever. 193 

result, there is a retention of what is normally eliminated 
by the skin, and at once the toxic retention acts upon 
the nervous system, causing an abrupt and sudden rise 
of the temperature. Now this will not happen as long 
as perspiration is free, because then we have an elimina- 
tion of the toxic elements which would cause an elevation 
of temperature. The skin action ceases to act before 
the temperature jumps up, as in the case of sunstroke. 

Active muscular activity produces heat, and evidently 
does so because of the toxic by-products generated as 
the result of the muscular activity. 

Fever is also incurred by absorption from the alimen- 
tary tract, especially in the case of an infection and as 
the result of the by-products of germ activity. If a 
child eats food that sours on the stomach and in the 
bowels, that child may have fever from it, and the severity 
of the fever will depend upon the amount of germ action 
and quantity of toxins formed by them. 

Germs are always present in the alimentary tract. 
The toxins, which are the by-products of germ develop- 
ment, are the most potent of all toxins from without 
which will effect a sudden rise of temperature. There 
is considerable variation in the amount of the stimulating 
effect upon the thermogenetic center by the toxins 
produced by the different varieties of infections. 

Since the by-products of some germs are much more 
toxic than the by-products of others, and the consti- 
tutional effects are much more severe from the toxins 
from one species of germs than from another, we have 
much more fatal results from one contagious disease than 
from another. 

In all infections and contagions, we can account for 
the fever readily on the ground of toxins of bacterial 
origin. 

In all cases of contagious fevers we find, first, there 
must be an exposure and an inoculation of the patient 



194 Interference With Nerve Function. 

by some infection; second, there must be a latent period 
called the incubation period, during which time we have 
the development of the bacteria within the human 
organism, and consequently the bacterial by-products of 
their development. We have no fever until time for the 
production and absorption of these toxins. 

We cannot conceive of any fever that we cannot 
account for on the ground of toxemia. 

If a limb is paralyzed, and if we remove interference 
with the nerve supply, and re-establish the normal 
processes of metabolism and circulation in that limb, we 
will witness an increase of heat production immediately. 
A limb that has become cold, will become feverish. The 
temperature will rise above the normal. This seems to 
be due to the fact that there has not been an elimination 
of the toxic elements of that limb which have accumu- 
lated during the existence of the paralysis. 

When the circulation and metabolic processes are re- 
established, the toxic elements that have been retained 
in the limb are thrown into the circulation as a result of 
relieving interference with nerve supply to the lower 
extremities and re-establishing circulation and absorp- 
tion. We have had a temperature of from one and a 
half to two degrees above normal ensue and last for an 
hour or two following treatment, but here again we 
know that it is the toxins that are retained in that limb 
that was paralyzed before treatment, thrown into the 
general circulation after treatment, which become the 
exciting cause of stimulation and excessive action of the 
thermogenetic centers, and the consequent elevation of 
temperature. 

In the case of typhoid fever we first have an infection 
of the alimentary tract, possibly two weeks before the 
invasion of fever. We have then what is known as the 
incubation stage, during which time we have the develop- 
ment of the bacteria, and by the end of that time we have 



Etiology — Fever. 195 

a sufficient production of toxins which act upon the 
nerve centers, after their absorption, to produce fever. 
Toxins, then, are the result of the pathological process 
of germ development. We have germ development in 
pyors patches, with a continuation of the production of 
toxins and a consequent continuation of the fever. 

It is well to remember that the germs of themselves 
do not cause fever, but it is the by-products of their 
development that excite nerve action and thus cause the 
fever. 

We find that by exciting or stimulating the direct 
nerve supply to the small intestines, we can establish 
normal autoprotection and we can in this way stop the 
pathological processes of typhoid fever, and when we do 
so, we have stopped the process of the formation of 
toxins which feed the fever; hence the result of our 
treatment breaks the course of typhoid fever. 

On the other hand, we are also enabled to stimulate 
the action of the skin, and thus eliminate toxic elements 
from the circulation. By stopping the production of 
toxins, and by increasing the elimination of those already 
produced, we find our patient is soon rid of typhoid fever. 
This may be done in most cases by producing a condition 
of nerve supply and vital activity in the bowel sufficient 
to stop the pathological processes of the fever. 

I will quote below my experience with a couple of 
cases of typhoid fever to show the effects of the develop- 
ment of normal nerve supply, and sufficient vital resist- 
ance to stop the bacterial action in the region affected by 
this fever: 

I was called one morning to see a patient who had 
been confined to his bed with typhoid fever for two 
weeks. I got a good adjustment, a good stimulation of 
the nerve supply to the local zone of infection by reliev- 
ing the contraction of the musculature of the spine of 
that region from whence came the nerve supply that 



196 Interference With Nerve Function. 

supplied the regions affected by the typhoid. The fever 
dropped from 103 to 101 in about ten to fifteen minutes. 
I did not remain long in the room, and when I got to my 
office the wife of the man called me up over the telephone 
and said: "What shall I do with my husband, he is just 
sweating so that the whole bed is wet?" I replied, "Let 
him sweat." Before noon she called the second time, and 
said, "What shall I do? He is just sweating streams of 
perspiration." Again I 'phoned, "Don't stop the sweat; 
if you do, his fever will come back again." By this time 
his fever had gone entirely and his temperature was 
slightly subnormal. 

In the afternoon he did not stop perspiring. They 
sponged him with cold water and chilled him through. 
As a result of that, in about fifteen minutes he had a 
little fever. As soon as the reaction was perfect, he 
broke into the perspiration again. The poor woman was 
so distressed that she called the former doctor. After 
this the writer refused to visit the patient any more. But 
the man, in spite of the cold sponging that caused a slight 
return of the fever, had no more fever of any consequence. 
He got well quickly and one adjustment accomplished 
the work of stopping the fever. 

We cannot always get the free perspiration after an 
adjustment. Have had cases in which it was hard to 
get any skin action for two or three days. We may work 
two or three days sometimes to break up an attack of 
typhoid fever. 

We remember one time of being called to see a boy 
about fourteen who was suffering with typhoid fever, the 
walking variety, of two weeks' standing. He began to 
have hemorrhages from the bowels. When hemorrhages 
began they got excited about him and sent for the author. 
When we saw the case we at once diagnosed it to be a 
case of typhoid fever, and that was the diagnosis of two 
other physicians. We gave the boy a good adjustment 



Etiology — Fever. 197 

about seven o'clock in the evening. He broke out in a 
profuse perspiration immediately. At the time of 
examination the patient's temperature was 104 plus and 
pulse rate 120. The next morning at nine o'clock we 
found him with a normal temperature and a pulse of 72. 
We wanted his bowels to remain open, consequently we 
stimulated the nerves to the bowels to create that condi- 
tion. He got along nicely three or four days, the bowels 
moving freely. The boy was sleeping and up walking 
around and had an uncontrollable appetite. 

The mother got alarmed because she thought the 
bowels were moving too freely, and without my knowl- 
edge or consent, she sent to the drug store and got a 
supply of calomel and gave the boy a heroic dose. As a 
result of that mercurial purge, the hemorrhage of the 
bowels was re-established. Those bowels had not had 
time to heal properly from the ulceration. 

When we heard of what had been done we refused 
to treat the case further. They called in two doctors 
and they treated his bowels for about ten days before 
they got him straight, and they said this: "We will 
have to acknowledge that Dr. Gregory did stop the 
fever." The patient had no fever after the night of the 
first adjustment. 

We believe we are justified in our conclusion that 
fever is the result of toxins and they are the result of the 
action of germs, and that germ action is permitted by 
lowered vitality or lack of autoprotection. When we 
establish normal autoprotection, we stop germ growth 
and development and when we start the skin to action 
we eliminate the toxins. When the toxic production is 
stopped and when the toxins are eliminated there is 
nothing to feed the fever and we can surely get rid of it. 
Many cannot believe this and many will continue to die 
by the orthodox route when they could get well by the 
use of rational methods. 



PART III. 

NERVE SUPPLY. 

CHAPTER I. 

NERVE SUPPLY. 

A KNOWLEDGE of the nerve supply to the different 
organs, viscera, and parts of the body, is necessary 
from the standpoint of diagnosis and from the 
standpoint of treatment by practitioners who practice 
chiropractic spondylotherapy, or any other method of 
spinal treatment. 

The most important feature of this subject from the 
standpoint of spinal treatment is to understand the con- 
nection between the nerves from the different segments 
of the spine and the organs supplied. We therefore do 
not study so much the branching and names of the 
branches of nerves to the different muscles, as we do the 
connection between the spinal segments and the different 
viscera and extremities. 

For the above reasons we study the nervous system 
from an entirely different standpoint than the ordinary. 
In the study of the subject of nerve supply, we see mani- 
fest a very important precautionary arrangement in the 
nerve supply to the different parts and more especially 
the principal viscera and organs of the body. 

This arrangement consists of nerves from different 
segments of the spine supplying, or helping to supply, 
directly or indirectly, the different viscera and parts of 
the body. This arrangement affords the best possible 
protection in the case of interference with any one nerve 
to any organ or part for the reason that the other sources 
of nerve supply would not likely be interfered with at 
the same time. 

199 




SCHEME OF J THE ORIGIN AND 
DISTRIBUTION OF THE SPINAL 
NERVES, SHOWING THE SPINAL 
NERVE SUPPLY OF THE DIF- 
FERENT VISCERA AND ORGANS 
OF THE HUMAN BODY. 



5-6-7^8 CERVICAL TOGETHER 
WITH THE FIRST DORSAL 
PAIRS OF SPINAL NERVES 
FORMS THE BRACHIAL 
PLEXUS, THEY ALSO SUP 
PLY THE HANDS, ARMS 
AND SHOULDERS. 



THE TWELFTH THORACIC AND 
ALL THE LUMBAR AND SAC- 
RAL PAIRS OF SPINAL 
NERVES FORMS THE LUMBO- 
SACRAL PLEXUS , THEY ALSO 
SUPPLY THE FEET , LEGS 
AND HIPS. 



Nerve Supply. 201 

If one portion of the nerve supply to any organ is 
interfered with, then the remaining nerves that partly 
supply this organ will maintain their vitality and function 
in a measure. 

Each organ possesses a direct nerve supply from the 
spine, which supply will have the most influence 
upon that organ, and in case of lesions affecting the 
principal nerve supply, the derangement of the function 
of the organ is more marked, whereas, if the nerves that 
are less important, as to the amount of supply fur- 
nished, are interfered with, then the derangement or 
malfunction of the organ will be less correspondingly. 

In case of irritative lesions of the peripheral afferent 
nerve endings in any organ or part of the body, then the 
impulse excited thereby is transmitted to the spinal cord 
by way of the most abundant and most direct afferent 
nerve supply; consequently the reflex lesions of the 
spine are most marked at that segment of the spine 
giving off the greatest proportion of the nerve supply to 
the organ affected. 

In our study of the nerve supply in this connection, 
we will consider the nerve supply to the principal organs 
and parts of the body individually by enumerating their 
direct and indirect nerve ramification, and consequently 
the direct and indirect points of spinal lesions where these 
organs may be affected, as they pass from the spinal 
column and from the brain. 

In studying the nerve supply to the viscera of the 
trunk, we find according to our anatomical text-be oks 
that the apparent supply only is given, and usually the 
nerve supply is given by stating that it is from one of the 
ganglia of the sympathetic system that is situated in the 
relative portion of the trunk, and sometimes the nerve 
is given and appears microscopically to be from a terminal 
ganglia of the sympathetic that is given off from one of 
the great ganglia, as the cardiac, solar, or pelvic plexus. 




NERVE SUPPLY OF THE SCALP 



Nerve Supply. 203 

We find it necessary, then, to trace the branches that 
join both the great ganglia and terminal ganglia back 
to their spinal or cranial origin, that we may be able to 
comprehend the regions of the spine where we may affect 
an organ, or which spinal nerves supply the function to 
the organs, and at what points spinal lesions may interfere 
with nerves that affect an organ through the ganglia that 
directly supply it. 

We also give some attention to the spinal and cranial 
nerves, and more especially to spinal nerves that join 
the terminal ganglia of the sympathetic, which supply 
the different viscera, and which terminal ganglia are 
situated in approximate relation to the organs supplied. 
In some cases the cells of the terminal ganglia are situated 
within the walls of the viscera that they supply. 

Nerve Supply to the Scalp. — We will enumerate 
the different spinal nerves that supply terminal fibers to 
some portions of the scalp, some to greater and some to 
lesser portions: 

1. Suboccipital. 

2. Great auricular. 

3. Posterior auricular. 

4. The occipital third. 

5. The occipital minor. 

6. The occipital magnus. 

7. Fourth cervical per circulation. 

1. The suboccipital nerves are given off and constitute 
the first pair of nerves of the spinal cord, and pass out 
from the neural canal through the post condyloid notches 
on either side between the posterior arches of the atlas 
and the occipital bone. The suboccipital nerves give off 
branches of distribution which pass upward and ramify 
the scalp, and thence pass forward to and supply the 
forehead, and thence continue downward to the eye- 
brows. This pair of nerves give the most direct and the 
most extensive nerve supply to the scalp. 



204 Nerve Supply. 

2. The great auricular nerves, whose fibers of origin 
are traced to the second and third pair of cervical nerves, 
ramify regions of the scalp around and adjacent to the 
ears on either side. 

3. The posterior auricular pair of nerves which are 
given off from the second pair of cervical nerves, helps 
to supply portions of the scalp posterior to the ears. 

4 and 5. The occipital minor and occipital third pair 
of nerves affect small portions of the scalp by direct 
ramification. 

6. The occipital magnus nerves pass to and supply 
the lateral sides of the scalp, anterior to the beginning 
and ascending portions of the occipital nerves. 

7. The fourth cervical pair of nerves have an indirect 
effect upon the scalp. This is because of their influence 
upon the circulation. They form principally the phrenic 
nerve, and influence the lungs and diaphragm, and are 
responsible for their expansion; hence the middle cervical 
nerves by affecting the circulation of the thoracic cavity, 
have a compensatory influence upon the circulation of the 
brain. Any failure of the expansion of the lungs and 
of the diaphragm may cause a congested and a throbbing 
in the brain, because of the excess of blood in the brain; 
whereas, on the other hand, a free expansion of the lungs 
and of the tissues around them, as the pleura and dia- 
phragm, will prevent the congestion of the brain. 

The circulation of the brain is intimately associated 
with the vascular supply to the scalp, by means of capil- 
lary connections between the blood vessels which pass 
between the bones of the scalp, through the sutures of 
the articulations. 

We have also an indirect effect upon the scalp from 
the different segments of the spine, down to and includ- 
ing the tenth segment. This is because of the action of 
these nerves upon the glands of the skin. All the nerves, 
down to and including the tenth, have an effect upon 



Nerve Supply. 205 

the skin of the body from that segment from which they 
arise upward. The tenth, however, has an effect upon 
the integument of the body, both below and above; 
consequently is the central place for skin action of the 
entire body. 

Alopecia is one of the most frequent results of a 
failure of the nerve supply to the scalp. In the treatment 
of this trouble it is well to consider other factors than 
the nerve supply. As a rule, the muscular tissues of the 
scalp are wasted or partly absorbed, due to an interference 
with the trophic nerve supply to the scalp. Massage 
and vibratory treatment of the scalp will stimulate and 
re-establish the formation of the muscular tissues, and 
also increase the vascularity of the scalp, both of which 
conditions are necessary to the development of the hair. 

A development of muscular tissues and restoration of 
the normal nerve supply will induce a healthful condition 
of the scalp, which is necessary to -overcome alopecia. 
From the experience we have had, we are sure that a 
great majority of the cases of alopecia may be relieved. 
Under the influence of the normal nerve supply and 
increased vascularity and muscular development of the 
tissues of the scalp, the hair may be caused to grow again 
on a head that has long been bald. 

Nerve Supply to the Brain. — The brain is the 
greatest accumulation of nerve matter in the body, and 
is the most important of any nerve matter of the entire 
system. The brain itself being composed of nerve 
matter, we would not at first think of a nerve supply 
to the brain, but we find that nerves ramify the brain 
substance and the meninges of the brain. 

The circulation of the brain and the metabolic pro- 
cesses thereof, and also the functioning of the brain, is 
dependent upon the nerve supply to it. We will enu- 
merate the principal nerves that supply and affect the 
brain, under the following headings: 




NERVE SUPPLY OF THE BRAIN 



Nerve Supply. 207 

1. Lumbar connections. 

2. Suboccipital nerves. 

3. Upper thoracic nerves. 

4. Lower thoracic nerves. 

5. Lower cervical nerves. 

6. Fourth cervical nerves. 

7. Irritation of any nerve. 

The suboccipital nerves affect the meninges of the 
brain through their branches given to the formation of the 
recurrent meningeal nerves. The fourth cervical nerves 
affect the brain by influencing the compensatory circula- 
tion between the cranial and thoracic cavities. 

The lower cervical nerves have an indirect action 
upon the brain, or rather upon the circulation of the 
brain, because of their supply and effect upon the muscles 
of respiration. In this way the expansion of the chest 
or thoracic cavity is affected, and the expansion of the 
thoracic cavity indirectly affects the circulation of the 
brain. 

The upper thoracic nerves affect the brain, its metabo- 
lism, and functional activity because of their connection 
by way of the white rami communicantes which join the 
sympathetic gangliated cords and pass with the superior 
rami stream to the superior cervical ganglia. From this 
point impulses are carried by way of the gray rami on 
to the cranial nerves, which rami after joining the cranial 
nerves, follow them in both directions, back to their 
origin in the brain substances, and also throughout their 
peripheral ramifications. 

The lower thoracic nerves have a very indirect yet 
positive action upon the brain. They have an influence 
upon the circulation of the brain because of phrenic 
anastomoses. The lower thoracic nerves from the ninth 
to the twelfth, communicate with the terminal branches 
of the phrenic nerve, which has such a decided influence 



208 Nerve Supply. 

upon the circulation of the thoracic cavity and conse- 
quently upon the circulation of the brain indirectly. 

The lumbar connections have an important and 
positive influence upon the condition of the mind and 
brain. This connection is undoubtedly through the 
communication of the lumbar nerves with the terminal 
branches of the pneumogastric in the hypogastric or 
pelvic plexus. The evidence of this is more marked in 
functional manifestations observed in clinical experience 
than in anatomical tracings. 

Irritation of Any Nerve. — The irritation of any 
nerve causes waste of nerve energy. Any waste of nerve 
energy depletes the general store. It is a well-known 
fact that persons suffering with toothache or intense 
pain in any part of the body, have not the normal equi- 
librium of mental action, cannot think as they would 
normally, and for this reason we consider nerve waste 
detrimental to the normal functional activity of the brain. 

Nerve Supply to Face and Neck. — The principal 
portion of the nerve fibers ramifying and supplying the 
integument of the face and neck, is derived from cranial 
nerves and from the cervical plexuses. The dorsal 
nerves also affect the circulation of the skin of the face 
and upper parts. The nerves supplying the face and 
neck may be enumerated as follows: 
I. Facial nerves. 
II. Trigeminal nerves. 

III. Upper four cervical nerves. 

IV. Upper five thoracic nerves. 
V. Tenth pair of thoracic nerves. 

I. The Facial Nerves are the seventh pair of 
cranial nerves and help in the supply of the entire surface 
of the face supplying both the skin and facial muscles. 

II. The Trigeminal Nerves. — This pair of nerves 
is the fifth pair of cranial nerves and they help supply 
the skin of the face, and also the deeper tissues through 




NERVE SUPPLY OF THE 
FACE AND NECK. 



210 Nerve Supply. 

the ophthalmic, superior maxillary and inferior maxillary 
branches. 

III. Upper Cervical Nerves. — The upper four 
pairs of cervical nerves give off the branches forming the 
cervical plexus which are distributed to the muscles and 
skin of the neck and face. The upper cervical nerves 
become involved in cases of barber's itch and other 
eruptions and diseases of the face. 

IV. Upper Thoracic Nerves. — The upper five or 
six pairs of nerves of the upper thoracic region furnish 
the white rami communicantes which form the upward 
stream which joins the gangliated cords of the sympa- 
thetic and sends fibers by way of the superior cervical 
ganglia, and in this way affect the glands of the skin of 
the face and neck. These nerves affect the action of 
both the sebaceous and sweat glands. 

V. Tenth Thoracic Nerves. — The tenth pair of 
thoracic nerves, because of their influence upon skin 
action and elimination, affect skin conditions. Their 
action is general and produces decided influence upon 
the skin action of the neck and face. 

The tenth pair of thoracic nerves also, through their 
influence upon the amount of the elimination of the 
kidneys, decrease the amount of elimination through 
the skin. 

These nerves also join the terminal branches and 
have a reflex influence upon the fourth pair of cervical 
nerves which join in the formation of the cervical plexuses, 
and in this way they affect directly the organs supplied 
by the brachial plexus, especially the parts supplied by 
the fourth pair of cervical nerves. 

NERVE SUPPLY TO NASAL CAVITY 

The nerve supply to the nasal cavity is especially 
important to understand and in the treatment of nasal 
catarrh and other diseases of the 




NERVE SUPPLY OF THE 
NASAL CAVITIES. 



212 Nerve Supply. 

!1. Third pair of cervical nerves. 
2. Fourth pair of cervical nerves. 
3. The fifth pair of thoracic nerves. 
4. The tenth pair of thoracic nerves. 

The direct supply that mostly affects the nasal cavity 
is derived from the middle cervical region. The normal 
condition of the nasal cavity is dependent upon the 
integrity, principally of the third and fourth cervical 
pair of nerves, while the indirect supply, affecting the 
nasal cavity, is from the upper thoracic nerves, more 
especially from the fourth and fifth thoracic pair of 
nerves. 

The upper thoracic nerves ramify and supply the 
nasal cavities by way of the white rami communicantes 
to the superior cervical ganglia, and thence by way of 
the gray rami to the terminal ganglionic supply of the 
nasal cavities. 

The Tenth Pair of Thoracic Nerves. — These 
nerves have the most influence upon general skin action 
of any pair of nerves. 

Any interference with this pair of nerves will interfere 
materially with the general skin action and consequently 
affect the action of the mucous membranes of all parts 
of the body, but more especially with the action of the 
mucous linings of the nasal cavities. 

The mucous membranes will in a way make up for 
the failure of action of the skin as in the case of coryza, 
in the case of bad colds. 

Interference with the tenth pair therefore will affect 
the action of the mucous membranes, and when we 
relieve all interference with the tenth pair of nerves we 
thereby re-establish the general skin action and thus 
relieve the extra work imposed upon the mucous mem- 
branes because of interference with the skin action. 

Nerve Supply to the Teeth and Gums: 

1. Third pair of cervical nerves. 




NERVE SUPPLY OF THE TEETH 8GUMS 



214 Nerve Supply. 

2. Fourth pair of cervical nerves. 

3. Fifth pair of thoracic nerves. 

4. Tenth pair of thoracic nerves. 

The fourth pair of cervical nerves seem to ramify 
very directly, and to have the most decided influence 
upon the teeth and gums of any pair of nerves. They 
join the trifacial nerves, and it is perhaps through this 
route that most of the impulses are carried to the teeth 
and gums. 

The fifth thoracic nerves affect the teeth and gums, 
and other organs of the head and throat, through the 
white rami communicantes connecting with the sympa- 
thetic cords, and by way of the superior cervical ganglia, 
which send branches to the cranial nerves. 

The tenth pair of thoracic nerves, it seems, has an 
influence upon the teeth and gums. The tenth pair of 
thoracic nerves affect the kidneys, and we have asso- 
ciated with kidney trouble certain conditions of the 
gums that are evidence of disease of the kidneys because 
of this almost uniform association of these troubles. The 
tenth pair of thoracic nerves is central place for skin 
action. It is possible that through the influence upon 
the skin that we have the teeth and gums affected, also, 
as they belong more especially to this portion of the 
anatomic or histological structures. 

Nerve Supply to the Tonsils. — We enumerate 
below the nerves that directly and indirectly affect these 
organs : 

1. Glosso-pharyngeal. 

2. Pneumogastric nerves. 

3. Fifth thoracic nerves. 

4. Middle cervical nerves. 

5. Seventh cervical nerves. 

6. The first cervical nerves. 

7. The second cervical nerves. 

The nerve supply to the tonsils seems to be most 




NERVE SUPPLY OF THE TONSILS 



216 Nerve Supply. 

direct from the fifth and sixth cervical nerves. The 
seventh cervical, however, seems to have a direct action 
in many cases upon the tonsil. Certain experiences we 
have had in making adjustment of the seventh cervical, 
prove conclusively that there is an influence, directly or 
indirectly, that has a decided effect upon the condition 
of the tonsil. 

The pneumogastric nerve affects the tonsil by giving 
off a branch thereto, but we do not affect the pneumo- 
gastric by spinal treatment, as it is a cranial nerve, 
except through the connections with the pneumogastric 
from the first and second cervical nerves. For this reason 
we have an indirect connection between the first and 
second pair of cervical nerves and the tonsils. And, 
further, we have a like connection with the glosso- 
pharyngeal nerves from the first and second cervical 
pairs of nerves. 

From the fifth thoracic pair of nerves we have a con- 
nection with the tonsils by way of the upper stream of 
white rami communicantes and the superior cervical 
ganglia, and their connection with the pneumogastric, 
glosso-pharyngeal, and other cranial nerves. 

The tonsils receive a decided nerve supply through 
the sympathetic branches of the glosso-pharyngeal nerves, 
and from the pharyngeal plexus, which branches form the 
plexus tonsillaris. 

Nerve Supply to the Pharynx. — We enumerate the 
following nerves that have the most direct action and 
that indirectly affect the pharynx: 

1. First cervical per vagus. 

2. Second cervical per vagus. 

3. Fifth and seventh cervicals. 

4. Upper dorsal per sympathetic. 

5. Nerves per pharyngeal plexuses. 

6. Nerves per glosso-pharyngeal plexuses. 

7. Lower spinal nerves per phrenic and vagus. 




NERVE SUPPLY OF THE PHARYNX 



218 Nerve Supply. 

The above enumeration is explanatory of the con- 
nections and manner in which the nerves enumerated 
affect or help to supply the pharynx. 

Nerve Supply to the Throat and Larynx. — We 
enumerate the following nerves that directly and indirectly 
ramify and affect the functions of the throat and larynx: 

1. Pneumogastric. 

2. First cervical. 

3. Second cervical. 

4. Fourth cervical. 

5. Seventh cervical. 

6. The eighth cervical. 

7. The fifth thoracic. 

The vagus affects the throat and larynx per superior 
and recurrent meningeal plexuses. 

The first pair of cervical nerves affect the throat and 
larynx through the same channels by giving a branch to 
the vagus. 

The second pair of cervical nerves ramify directly 
the larynx and throat or send branches to terminal 
ganglia which supply these organs. 

The fourth pair of cervical nerves also send direct 
branches to the throat and larynx or to the terminal 
ganglia supplying them. 

The seventh pair of cervical nerves send branches or 
fibers directly to the terminal plexus of this region. Some 
cases of sore throat are directly affected by seventh 
cervical adjustment. 

The eighth pair of cervical nerves affect the throat 
and larynx in the same way as does the seventh pair, 
and often have a very decided influence upon the func- 
tions of these organs. 

The fifth thoracic pair of nerves has a most potent 
influence upon conditions of the throat. The connection 
existing between the fifth thoracic nerves and throat is 
by way of the upward stream of white rami communi- 



, jy 




NERVE SUPPLY OF THE 
THROAT AND LARYNX. 



220 Nerve Supply. 

cantes and by way of the superior cervical ganglia of 
the sympathetic. We have most positive results in cases 
of sore throat by giving a thrust to the fifth thoracic 
vertebra for the relief of the fifth thoracic nerves, espe- 
cially the nerve on the right side. 

This fact is of special importance to us in the treat- 
ment of not only acute cases of sore throat, but also in 
the treatment of the tonsils, larynx, pharynx, posterior 
nares and salivary glands. The fifth pair of thoracic 
nerves, the one on the right side especially, are involved 
in cases of diphtheria, scarlet fever, mumps, croup, and 
other diseases that affect the throat. 

Nerve Supply to the Eyes: 

1. Optic nerves. 

2. First cervical nerves. 

3. Fourth cervical nerves. 

4. The upper thoracic nerves. 

5. The fifth thoracic nerves. 

6. The tenth thoracic nerves. 

7. The first two lumbar nerves. 

The optic nerves pass directly from the cortical 
surfaces of the occipital lobes forward to the retina of 
the eye. The optic nerves, however, do not seem to 
possess the properties of function of the ordinary nerves. 
They owe their power of action, and of transmission, 
entirely to the communicating branches they receive 
from the spinal nerves. 

The first pair of cervical nerves join and help to 
form the recurrent meningeal nerves, and therefore affect 
the nourishment of the cortical surfaces of the occipital 
lobes of the brain. 

The fourth pair of cervical nerves have the most 
direct, most decided, and most positive effect upon the 
optic nerves affecting their visual power, and especially 
influencing the power of action of the pupils of the eyes. 

We have restored sight by an adjustment of the 




NERVE SUPPLY OF THE EYE. 



222 Nerve Supply. 

fourth cervical vertebra. This is because of the removal 
of interference with the fourth pair of cervical nerves. 

The first and second pair of thoracic nerves have an 
influence upon the action of the ciliary muscles of the 
eye, and for this reason lesions of the upper thoracic 
region may become factors in the derangement of vision, 
especially of the power of accommodation. 

The fifth thoracic pair of spinal nerves have an action 
upon the cranial nerves by means of the upward stream 
of white rami communicantes, and they seem to affect, 
mostly, the eyeballs. The author has had some cases 
who complained of pain in the eyeballs; this pain was 
immediately relieved by removing interference with the 
fifth pair of thoracic nerves, or by a fifth thoracic adjust- 
ment. 

The effect of the tenth pair of thoracic nerves upon 
the eyes, has long been observed in clinical experience. 
Associated with certain kidney troubles, we have certain 
visual troubles. Now, the manner in which the tenth 
pair of thoracic nerves affect the optic nerves is obscure. 

The most plausible connection that we can see, and 
probably the only connection we can figure, is through 
the communication of the tenth thoracic nerves with the 
phrenic pair of nerves, the phrenics coming as they do 
from the fourth cervical, and these nerves control the 
power of sight of the eyes. We cannot explain this 
connection by means of the white rami fibers joining the 
sympathetic, because the tenth pair of thoracic nerves 
belong to that division of the spinal nerves that join 
the downward stream of the white rami communicantes. 

This fact leaves the only channel of connection that 
we can trace between the eyes and the tenth thoracic, 
by way of the afferet fibers of the phrenic nerves which 
affect reflexly thatsnegment of the cord giving the 
fourth pair of cervical nerves, which control the visual 
apparatus of the eye. 



Nerve Supply. 223 

Eye affections have come under our notice in which, 
when we adjust the tenth thoracic vertebra, we produce 
certain positive and decided effects immediately in the 
eyes. Cases in which there is a retention and congested 
condition in the eyelids and in the orbital regions, we 
notice immediately after an adjustment an intense 
exudate and flow of tears from the eyes. 

We have had patients wet their handkerchief in a 
few minutes' time after a tenth thoracic adjustment. 
Now this phenomenon seems to be due to the effect of 
the tenth thoracic upon skin action. Again we note that 
in affections of the eyelids, the tenth thoracic seems to 
have the most effect upon the eyes, especially the eyelids. 

The first lumbar nerves have a reflex connection with 
the eyes. This is evidenced by the fact that when we 
find tenderness of those nerves, the patient will involun- 
tarily close the eye when we palpate the tender first 
lumbar nerve. This is a phenomenon we have often 
noticed, but can give no explanation except it is because 
of the connections through the sympathetic system. In 
some cases we have found that the first lumbar lesions 
seem to have an influence upon the health and vision of 
the eye, because of the fact that after an adjustment of 
the first lumbar vertebra eye troubles will disappear, but 
we have not adjusted this nerve alone, however, and 
studied effects, but always in connection with other 
nerves that affect the eye. 

Nerve Supply to the Ear. — The most direct action 
we have upon the ear is through the upper cervical and 
upper thoracic nerves. We enumerate the following as 
furnishing the nerve supply to the organs of hearing: 

1. Acoustic nerves. 

2. First cervical nerves. 

3. Second cervical nerves. 

4. The third cervical nerves. 

5. The upper thoracic nerves. 



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NERVE SUPPLY OF THE EAR, 



Nerve Supply. 225 

The acoustic nerves seem to depend wholly upon the 
connecting branches of other nerves for the power of 
functioning. 

The first and second and third pairs of cervical nerves 
join and affect the terminal ganglia which supply the 
apparatus of hearing, and also affect the circulation of 
the brain per the recurrent meningeal nerves, and thus 
have an influence upon the auditory centers in the brain. 

The upper thoracic nerves affect hearing through the 
upward stream of the white rami communicantes and 
through the superior cervical gangliated substation which 
sends gray rami directly and by way of the internal 
carotid plexus to all of the cranial pairs of nerves. 

Nerve Supply to the Tongue: 

1. Hypoglossal. 

2. Glosso-pharyngeal. 

3. The upper cervical. 

4. The lower cervical. 

5. The fifth thoracic. 

The first two of the above are of the cranial nerves, 
which furnish branches of ramification to the tongue. 

The upper cervicals, the first and second, have an 
effect upon the tongue, because of branches given to the 
glosso-pharyngeal and hypoglossal nerves. 

The fifth to seventh cervical nerves may have com- 
municating branches to terminal ganglia of the sympa- 
thetic which gives off fibers that join the facial nerve. 
The fifth thoracic has decided action upon the tongue, 
and is especially involved in glossitis. The connection 
existing between the fifth pair of thoracic nerves and 
the tongue is by way of the upward stream of the white 
rami communicantes through the superior cervical ganglia, 
and from thence by way of the gray rami to the terminal 
ganglia supplying the tongue and the lingual nerves. 




NERVE SUPPLY OF THE TONGUE 






Nerve Supply. 227 

Nerve Supply to the Thyroid Glands: 

1. Pneumogastric. 

2. First cervical. 

3. Second cervical. 

4. The lower cervical. 

5. The fifth thoracic. 

6. Middle cervical ganglia. 

7. Inferior cervical ganglia. 

The first cervical nerves, and also the second cervical 
pair, join the pneumogastric, and therefore have an 
influence upon the pneumogastric fibers which join the 
pharyngeal plexus, and supply the thyroid gland. 

The lower cervical nerves directly ramify the thyroid 
gland, and are responsible for its condition to a consider- 
able extent. 

The middle and inferior cervical ganglia both send 
branches into the thyroid glands. The thyroid glands 
also receive a nerve supply from the inferior laryngeal 
nerves, and possibly also from the superior laryngeal 
nerves, both of which are partly made up of branches of 
the pneumogastric. 

The pneumogastric nerves help to supply the thyroid 
glands principally through the inferior laryngeal branches, 
but also may send branches of ramification by way of 
the superior laryngeal ganglia. 



5TH. D. V. /*, 




NERVE SUPPLY OF THE THYROID BODY. 



CHAPTER II. 
NERVE SUPPLY TO THORACIC VISCERA. 

WE will now turn our attention to the nerve supply 
of the thoracic cavity and viscera contained 
therein. The nerve supply to the thoracic 
cavity and organs is from different sources. 

1. Branches from the cranial and from the cervical 
nerves directly affect the thoracic viscera from above, 
while the upper portions of the spinal cord, and also the 
thoracic portions of the gangliated cords, send branches 
which contribute to the nerve supply directly to the 
organs of the thoracic cavity. 

2. From the lower thoracic and lumbar portions of 
the spinal cord we have connections with the phrenic 
and pneumogastric nerves, through which connection 
they influence the heart and other organs of the thoracic 
cavity. 

We will now consider the nerve supply to the lungs, 
and especially is this an important matter because of the 
more common and prevalent diseases that affect the 
lungs. 

Tuberculosis is the most common, most fatal infec- 
tious disease preying upon the human race. Tuberculosis 
is the direct or indirect cause of about one death in every 
seven. Diseases of the lungs of a fatal nature are more 
commonly due to tubercular infection than to any other 
exciting cause. 

In the treatment of lung diseases, such as tuberculosis, 
asthma, pneumonia, or other ailments, it is quite essential 
to understand which nerves supply and ramify the lungs, 
and which nerves indirectly affect or influence the 
pulmonary organs. 

Now, we cannot go into the etiology, pathology, 

229 



230 Nerve Supply. 

symtomatology, nor into an outline of the general methods 
of treatment of lung diseases, nor can we go fully into a 
description of the many nerves that may ramify or 
indirectly influence the lungs or organs of the thoracic 
cavity; but we want to enumerate the principal nerves 
and describe how they may reach and ramify or indirectly 
influence the pulmonary organs. We enumerate below 
the principal nerve supply to the pulmonary organs as 
follows: 

1. Pneumogastric. 

2. First cervical nerves. 

3. Fourth cervical nerves. 

4. Fifth to eighth cervical nerves. 

5. First and second thoracic nerves. 

6. Third to the sixth thoracic nerves. 

7. Ninth to the eleventh thoracic nerves. 

The first pair of spinal nerves that may affect the 
lungs is the first pair of cervical nerves or the suboccipital 
pair of nerves. 

First, these nerves join and help to form the recurrent 
meningeal nerves that directly supply the dura mater and 
deeper coverings of the brain. Through interference 
with the action of the suboccipital pair of nerves, the 
nutrition and function of the brain is interfered with, 
and as the centers for the control of all organs and parts 
of the body are mostly contained in the brain or enceph- 
alon, any interference with this organ may affect the 
lungs as well as many other organs or parts. 

Second, the suboccipital pair of cervical nerves join 
the vagus or pneumogastric pair of nerves. The pneumo- 
gastric pair of nerves, as the name implies, ramifies and 
supplies the lungs as well as the heart and also other 
viscera of the thoracic and abdominal cavities. 

Any interference with the pneumogastric pair of 
nerves, either through disturbance of the brain or its 
meninges, from interference with the recurrent me- 



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NERVE SUPPLY OF THE LUNGS 



232 Nerve Supply. 

ningeal nerves, or through interference with the nerves 
joining the pneumogastric, as from the suboccipital 
nerves, will interfere with the pulmonary organs to a 
greater or less extent. 

The next pair of nerves in the cervical region affect- 
ing the lungs that we wish to call the reader's attention 
to, is the fourth pair of cervical nerves. From this pair 
of nerves originate the phrenic nerves principally; in 
fact, entirely, except auxiliary branches from the third 
and fifth pair of cervical nerves. 

The ramification of the phrenic nerves have a direct 
effect upon the pulmonary organs because of their dis- 
tribution to the pleura, pericardium, diaphragm, etc. 

These nerves have a direct effect upon respiration by 
affecting the expansion of the pleura and diaphragm, and 
they are known as the internal respiratory nerves of Bell. 

By affecting the respiration and the expansion of the 
pulmonary organs, they affect, indirectly, the circulation 
of the cranial cavity, and we may relieve the congested 
condition of the brain by stimulating or removing inter- 
ference with the fourth pair of cervical and phrenic nerves. 

The next pair of nerves to which we would call your 
attention that may indirectly affect the lungs, affect 
the respiration by effecting the expansion of the 
chest; these are the external respiratory nerves of Bell, 
arising from the fifth and sixth cervical pair of nerves, 
namely: The long, or posterior thoracic nerves, and the 
anterior thoracic nerves, both external and internal 
branches. These nerves supply the muscles that assist 
in the expansion of the chest by supplying motor impulses 
to the respiratory muscles of the thoracic cavities. 

The long, or posterior thoracic nerves, supply the 
serratus magnus muscles which attach to the ribs through- 
out the thoracic region from the first down to, and 
including the eighth pair of ribs, while the anterior 
thoracic nerves pass under and supply the pectoral 



Nerve Supply to Thoracic Viscera. 233 

muscles, both major and minor. Thus these principal 
muscles of respiration are supplied by and affected by- 
interference with the brachial plexuses, and their roots 
of origin can be traced back to the fifth and sixth pairs 
of cervical nerves. 

An understanding of the ramification of the branches 
of the fifth and sixth cervical pairs of nerves, especially 
an understanding of the ramification of the long or 
posterior thoracic nerves, will explain to us how we may 
often relieve what seems to be an intercostal neuralgia, 
by relieving impingement of the fifth and sixth pairs of 
cervical nerves, and also explains some peculiar nerve 
tracings that are made by careful students or adjusters. 

In passing, we would call attention to the second pair 
of thoracic nerves. These nerves affect the bronchial 
tubes. They also affect the heart, and for the above 
reason they have an effect upon any cough. They may 
affect the lungs, heart, and circulation, but their influence 
upon the lungs is far overshadowed by that of the third 
pair of thoracic nerves, which ramify more directly the 
lungs and pleura. The upper portions of both the right 
and left lung are supplied by the third pair of nerves, 
also the central part of the upper portion of both lungs. 

The third pair of nerves almost wholly supply the 
pleuras from the top to the bottom, throughout their 
entire extension. 

They have the most effect, and ramify most com- 
pletely, the lungs and pleura of any nerves; for that 
reason their condition is most important in all cases of 
lung trouble, as well as in most cases of asthma. 

We have been told by one who claims to have paid 
very close attention, that the third thoracic spinous pro- 
cess, in tubercular cases, is usually to the left. We also 
find that the apex of the left lung is usually involved 
first in lung trouble. 

By Mr. Davenport we are told that in practically all 



234 Nerve Supply. 

cases of consumption the patient has contracted the habit 
of continually lying upon the left side. This fact will 
explain to a certain extent why the left lung, being the 
dependent one, as the patient sleeps, is more apt to 
become involved with congestion and also with infection 
of any kind. 

The fourth thoracic nerves have a direct influence 
upon the lung tissues. They supply the muscles of the 
heart and have a direct effect upon the circulation of 
the lungs, and branches from the fourth pair of thoracic 
nerves help to supply the lobes of the lungs through their 
connection with the fourth thoracic ganglia and with 
the cardiac plexus. 

The fifth equally supply the lungs, because the 
branches of these join into the formation of the cardiac 
plexus, from which the lungs receive their direct supply; 
further, the fifth nerves seem to have the greatest effect 
upon the stomach, especially the nerves from the left 
side of the spine; consequently anything that stimu- 
lates or anything that will furnish normal impulses to 
the stomach will assist in the secretion of the juices 
aiding in the digestion, and also assist the peristaltic 
movements of the stomach. 

Good digestion will help very materially in main- 
taining the nutrition and in the upbuilding of the patient. 
This metabolic stimulation will establish and increase 
the autoprotection that is necessary, that a patient may 
withstand the ravages and be equal to the task of over- 
coming the inroads of tubercular infection. 

In this connection we would also call your attention 
to the fifth and sixth cervical pair of nerves which 
supply the thyroid glands. These nerves are important, 
and have a decided influence upon the lungs, because 
of their influence upon the thyroid glands. These 
glands secrete the colloid material which is thrown 
into the general circulation and which has a direct 



Nerve Supply to Thoracic Viscera. 235 

influence upon the general metabolism of the organism. 
This will increase the building up of the cellular tissues 
of the body. Anything that will increase the tissues 
building will increase the power of resistance, and this 
vital resistance will aid materially in eradicating diseases 
of the lungs. 

The sixth pair of dorsal nerves have a direct action 
upon the diaphragm, and also the sixth pair send branches 
to a certain extent, into both the cardiac and the solar 
plexuses of the sympathetic system, and therefore they 
influence the nerve supply of both the thoracic and 
abdominal cavities. 

This pair of nerves also affects the general nervous 
system. Tubercular people are always neurasthenic. 
For this reason, when we affect the sixth pair of thoracic 
nerves and the sixth segment of the spinal cord, we will 
affect that nervous condition and strengthen up the 
nerve tone, and we thereby increase autoprotection and 
the vital resistance against the inroads of disease, and 
stimulate and build up the organs of both the abdominal 
and thoracic cavities. 

Now, in the above, we have briefly enumerated the 
principal nerve supply to the lungs. There are other 
nerves that will affect the lungs. We may mention that 
the kidney action and the tenth pair of thoracic nerves 
that control the skin action, have a direct effect upon 
the lungs because of the elimination by them of the 
effete and waste matter. 

Now the kidney and skin action are affected more 
from the tenth pair of thoracic nerves, probably, than 
any other one pair of nerves; since the tenth thoracic 
is central place for the skin action of the entire body. 
For this reason it is very important to remember that 
the tenth pair of thoracic nerves affect elimination in 
connection with all diseases of the lungs and of other 
organs or parts. 



236 Nerve Supply. 

The ninth, tenth and eleventh thoracic nerves join 
the terminal fibers of the phrenic nerves. The phrenic 
nerves contain both afferent and efferent fibers; hence 
involvement of the ninth to eleventh pair of thoracic 
nerves will, through the afferent fibers of the phrenic 
nerves, influence the lungs. There seems to be a compli- 
cation of the heart in most cases of kidney trouble which 
must be due to the communication of the nerves of the 
kidney region with the phrenic nerves, and it may 
be that the connection existing between lower thoracic 
nerves and the pneumogastric nerves is also responsible 
for involvement of the heart and lungs. 

It is also a fact that if any pair of nerves is involved, 
it would cause an extra expenditure of nerve energy, as 
nerve energy is wasted thereby, and any weak organ in 
the body will be the loser, and suffer because of the lack 
of the generation of the proper amount of nerve energy 
to supply all the normal needs of the body, and also the 
extra supply for the waste. 

In the treatment of cases of lung trouble we have 
had some remarkable results. We know that lung trou- 
ble will sometimes recover of its own accord. If it 
recovers unaided, will it not recover still better if we look 
after the nerve supply and remove all interference with 
the nerves that we have indicated above? 

We are sure that our success in the treatment of this 
disease will warrant us in saying that most cases of 
lung trouble may be removed and the patient restored 
to health. We have taken some extreme cases, and we 
have never failed to get good results in any cases yet 
that we have accepted and put under treatment, and we 
feel that it is a great blessing to humanity to have some 
competent way or method of successfully treating by 
relieving the nerve supply to the lungs from every source. 

The phrenic nerves also supply the pleura, thereby 
influencing the expansion of the lungs. 



Nerve Supply to Thoracic Viscera. 237 

The phrenic nerves also supply the diaphragm, and 
thus exert an influence upon the expansion of the thoracic 
cavity. The latter two phenomena both influence the 
heart action to a certain extent. 

The pneumogastric nerves are prime factors in the 
formation of the cardiac plexus. The pneumogastric 
nerves are affected directly by branches from the first 
and second pair of cervical nerves. For this reason, 
adjustment of the first and second cervical vertebrae will 
have a direct action upon the heart. This was demon- 
strated recently in the case of a man who, it was thought, 
had died on a street car, but who was restored quickly by 
an upper cervical adjustment. 

The upper thoracic nerves enter directly into the 
formation of the cardiac plexus, and send branches 
directly to the terminal ganglia supplying the different 
organs of the thoracic cavity. 

The second pair of thoracic nerves most directly 
influence the heart by stimulation of the vasomotor 
influences. Relief of the second pair of dorsal nerves 
will establish the normal impulses to the vasomotor 
nerve supply of the heart center and induce inhibitory 
control. The second thoracic nerves originate from a 
spinal segment immediately under the seventh thoracic 
vertebra, and the vasomotor action and inhibitory 
control may be obtained by concussion over the seventh 
cervical spinous process and the first and second thoracic. 
Percussion over the fourth and fifth cervical spinous 
process will stimulate vasomotor and vasoconstrictor 
action of the lungs. 

If the nerves are free, we get the normal impulse and 
normal heart action, provided no trauma exists. If, at 
any time, we wish to increase the action and excite an 
increased inhibitory control, we may do so by adding 
to the normal impulse by stimulating the centers from 
which the fourth pair of thoracic nerves originate. The 



238 Nerve Supply. 

centers of origin of the fourth pair of thoracic nerves are 
situated under the spinous process of the first thoracic 
vertebra. 

Nerve Supply to the Heart: 

1. Phrenic. 

2. Pneumogastric. 

3. Upper thoracic. 

4. Lower thoracic. 

5. Middle cervical ganglia. 

6. Inferior cervical ganglia. 

7. Superior cervical ganglia. 

The nerve supply to the heart is quite important; 
somewhat complicated, but for various reasons it should 
be thoroughly understood; and further, we should under- 
stand the nerves ramifying and supplying the heart 
directly, and then those influencing it indirectly. 

We find it quite necessary to have a thorough knowl- 
edge of those centers or segments in the spinal column 
giving off nerves that have a vasomotor effect upon 
these organs, also those centers giving off nerves having 
an inhibitory, and also those having a vasodilator effect 
upon the lungs and heart. The centers giving off nerves 
that have a constrictor influence upon the heart and 
aorta, are especially important in the treating of aneurism 
of the aorta. The centers giving off nerves having a. vaso- 
dilator effect, are more important in the treatment of 
asthma and angina pectoris, and also all diseases of a 
spasmodic nature of the thoracic region. 

Phrenics. — The phrenic nerves are given off princi- 
pally from the fourth pair of cervical nerves, but auxiliary 
branches from the third and fifth cervical nerves enter 
into their formation. The phrenic nerves enter also into 
the formation of the cardiac plexus, and have an impor- 
tant influence upon the nerve supply to all of the viscera 
of the thoracic cavity. They especially supply the 
pleuras, pericardium, and the diaphragm. The phrenic 




NERVE SUPPLY OF THE HEART. 



240 Nerve Supply. 

nerves control to a great extent the expansion and con- 
traction of the parts mentioned and their action decidedly 
influences the integrity of the heart's action. 

The method of resuscitating people who have become 
unconscious from sudden paroxysms, consists of tapping 
or percussing with the hands over the spinous processes 
of the fourth or fifth cervical vertebra. 

Pneumogastric. — The pneumogastric nerves directly 
influence the heart action. The pneumogastric nerves 
become affected by interference with the upper two 
cervical nerves which give off communicating branches 
that join them. 

Adjustment of the upper cervical vertebrae has 
restored patients to consciousness, because of this 
connection . 

Upper Thoracic. — The upper thoracic nerves have 
the most potent influence upon the heart. They supply 
most directly branches to the heart muscles. The 
second pair of nerves exert a vasomotor and vasocon- 
strictor influence upon the heart and aorta. 

Cases of thoracic and abdominal aneurism have 
yielded to the influence of a thrust to remove interfer- 
ence with the second pair of thoracic nerves. Cases of 
aneurism have also been restored to normal by percus- 
sion of the spinal centers from which originate the 
second pair of thoracic nerves. 

The centers of origin of the second pair of thoracic 
nerves are situated under the seventh cervical vertebra. 
According to Dr. Albert Abrams, percussion to constrict 
the heart and aorta should be given over the seventh 
cervical spinous process. 

The fourth pair of thoracic nerves directly ramify the 
muscles of the heart and have a direct inhibitory action 
as well as a vasomotor influence upon the heart. 

We have restored the heart beat after cessation from 



Nerve Supply to Thoracic Viscera. 241 

chloroform by a thrust to relieve the fourth pair of 
thoracic nerves. 

We may influence the heart's action by relieving the 
fourth pair of thoracic nerves and by so doing we restore 
the normal impulse to the heart. 

We may stimulate these same nerves by percussion 
immediately over the spinal centers from which the fourth 
thoracic nerves are derived. To do so, percussion should 
be applied over the first and second thoracic vertebrae or 
spinous processes thereof. By understanding and operat- 
ing upon these centers as above indicated, we have been 
able to reduce the heart beat from 100 to normal in 
from five to seven minutes' treatment, and the normal 
condition will be resumed in from thirty minutes to an 
hour after treatment. 

The lower thoracic nerves have an influence upon 
the heart action, and upon all organs of the thoracic 
cavity. The connection, however, seems to be due to 
the communication existing between the lower thoracic 
nerves and the terminal fibers of the phrenic nerves. 

The influence produced in the lower thoracic is quite 
different from that produced in the upper thoracic. 
While the upper thoracic supplies the vasomotor and 
inhibitory control, the lower thoracic supplies the vaso- 
dilator influences. If we have the normal nerve supply 
from the two regions, we have an equilibrium existing 
between the vasoconstrictor and vasodilator influences; 
consequently the normal condition. However, should we 
have a condition of vasodilation of the heart or the 
thoracic organs because of interference with the lower 
thoracic nerves, then all we need to do is to relieve the 
lower thoracic from the interference and establish the 
normal equilibrium. 

On the other hand, if we wish to obtain above the 
normal vasodilator influences, then it is necessary in 
addition to freeing the nerve from interference, to stimu- 



242 Nerve Supply. 

late the centers from which they are derived, and thus 
stimulate the motor roots of the nerves. This will 
increase the vasodilator action, provided we are treating 
in the lower thoracic region. 

The superior, inferior, and middle superior cervical 
ganglia of the gangliated cords, enter into the formation 
of the cardiac plexus, and directly supply the heart's 
action, and also exert an influence on all of the thoracic 
viscera. Their action seems to be vasomotor and vaso- 
constrictor in influence. 

Stimulation of the inferior cervical ganglia by per- 
cussion over the seventh cervical vertebrae will excite 
constriction, and increase the vasomotor effects upon the 
heart and aorta. 

There is also no doubt that any intense pain anywhere 
in the body will produce a reflex or sympathetic influence 
upon the heart's action. The gray rami branches from 
the upper thoracic ganglia of the gangliated cords of the 
sympathetic system, enter into the formation of the 
cardiac plexus, and therefore become factors in influencing 
the organs supplied thereby; consequently have an 
influence upon the heart's action. 

Nerve Supply to the Djaphragm: 

1. Phrenic. 

2. Pneumogastric. 

3. Lower thoracic. 

4. Middle thoracic. 

5. Diaphragmatic plexus. 

The phrenic nerves furnish a very direct and a very 
considerable portion of the nerve supply to the diaphragm 
and they come from the middle cervical region. The 
phrenic nerve supply is disturbed by spinal lesions inter- 
fering with the middle cervical nerves. 

The vagus nerves help to form the diaphragmatic 
plexus of the sympathetic, and also give branches to the 
diaphragm direct. 




NERVE SUPPLY OF THE DIAPHRAGM. 



244 Nerve Supply. 

The middle thoracic region, by direct ramification, 
supplies the diaphragm, and the supply seems to come 
from about the sixth and seventh thoracic nerves, while 
the lower thoracic nerves communicate with the phrenic 
nerves and influence the diaphragm, and also send 
branches into the formation of the diaphragmatic plexus 
of the sympathetic. The diaphragm receives branches 
also from the ganglia of the middle portion of the gan- 
gliated cords. 

The Esophagus. — The esophagus receives its nerve 
supply from the esophageal plexus, which is a terminal 
ganglia of the cardiac plexus of the sympathetic; it also 
receives white rami from the cervical nerves and the 
upper thoracic nerves, while the upper portion is supplied 
by the terminal ganglia of the cervical region. 

The thoracic aorta is supplied by the second, third 
and fourth thoracic nerves principally. The second 
thoracic nerves have a vasoconstrictor influence upon the 
aorta. Removing all interference with the second 
thoracic nerves gives us the normal constrictor influence 
upon the thoracic aorta, and they also influence the 
abdominal aorta. 

If at any time we wish to have more than the normal 
influence, which is necessary sometimes in aneurism, we 
may then enhance the constrictor influence by percussion 
over the seventh cervical vertebra. Thereby we stimu- 
late the roots of efferent nerves that form the second pair 
of thoracic nerves. 

Nerve Supply to the Mammary Glands. — The 
nerve supply to the mammary glands is from the inter- 
costal nerves that are given off from about the third to 
the fifth pair of spinal nerves inclusive. 

The sympathetic supply to the mammary glands is 
from the gray rami of the upper thoracic segment of the 
gangliated cords of the sympathetic by way of the gray 
rami branches, to the intercostal nerves. 




NERVE SUPPLY OF THE 
MAMMARY GLANDS. 



246 Nerve Supply. 

Another important division of the nerve supply to 
the mammary glands is the nerves which come from the 
brachial plexus. The brachial plexus gives off branches 
that supply both the back and the front of the chest. 
The intercostal nerves in front, both external and internal, 
enter into the supply of the mammary glands, and the 
long posterior thoracic gives branches to the axillary 
portion of the mammary glands, and especially to the 
glands of the axillary region. 

Affections of the breast may come, then, from inter- 
ference with nerves of the cervical region, especially the 
lower portion thereof, and from the thoracic region down 
to as low as the sixth pair. 

In the treatment of the diseases of the breast, it is 
well to look after the nerve supply from each segment 
of the spine that contributes to the supply of the mammary 
glands. If we should fail to do this, and confine our 
treatment to one spinal segment, we might miss other 
lesions that interfere with the integrity of other nerves 
that enter into the supply of the mammary glands. In 
this way we may fail to remove the nerve interference 
that may cause a continuation of the pathological process 
in diseases of the mammary glands. 



CHAPTER III. 
NERVE SUPPLY TO ABDOMINAL VISCERA. 

THE nerve supply to the viscera of the abdominal 
cavity is given off and supplied most directly 
from the lower thoracic portion of the spinal cord 
and lower thoracic portion of the gangliated cords of the 
sympathetic. All the nerves from these regions, from 
the sixth thoracic segment, down to and including the 
last thoracic segment, enter into the formation of the 
solar plexus, and ramify and mostly supply the viscera 
of the abdominal cavity. 

The abdominal organs are no exception to the general 
rule; consequently we find the nerve supply coming 
from different portions of the cerebro-spinal system and 
entering into the formation of the solar plexus, and 
helping to supply the viscera and organs of the abdominal 
cavity. 

The branches that come from other regions than those 
located approximate to the abdominal organs, do not 
have as decided an effect upon these organs as do the 
nerves from the lower thoracic portions of the spinal 
cord and sympathetic cords. 

We find that by means of an anastomosis existing 
between the pneumogastric and phrenic nerves supplying 
the abdominal organs from above, that the abdominal 
viscera are supplied and affected from both the nerves 
of the cranium and upper or cervical portion of the spinal 
cord. There is, also, an intermingling and communi- 
cation existing between the lumbar and sacral nerves 
below, with the terminal branches of the pneumogastric 
nerve from above, consequently the lumbar and sacral 
nerves also have an influence upon the viscera of the 
abdominal cavity. 

247 



248 Nerve Supply. 

The abdominal viscera, like those of the thoracic 
cavity, apparently receive their nerve supply from the 
terminal ganglia given off from the solar plexus. As the 
solar plexus and terminal ganglia also depend upon 
physiological impulses received from the brain and spinal 
centers, we find it necessary to study from what points 
of the spinal cord we would be enabled to influence the 
function of the sympathetic ganglia. 

Id the arrangement of the nerve supply affecting the 
viscera of the abdominal cavity, we find that same pre- 
cautionary arrangement as in the thoracic cavity whereby 
an organ is not deprived of its nerve impulses and conse- 
quent vitality and functional activity, because of inter- 
ference with any one pair of nerves. This is because the 
auxiliary supply from other segments of the cerebro- 
spinal system will maintain the life, and, perhaps, in a 
manner, maintain the functioning of the organ to a 
limited extent, although the more direct nerve supply 
might be interfered with or cut off. 

The fact that the viscera of the abdominal cavity do 
receive a nerve supply from different segments and 
portions of the cerebro-spinal system, emphasizes the 
necessity of removing spinal lesions in all portions, that 
all nerve supply may be free from interference to all the 
organs of this cavity. 

We notice one important change taking place in the 
arrangement, or relative arrangement of the centers 
exerting the vasomotor influences upon the viscera of 
the abdominal cavity, as compared with the viscera of 
the thoracic cavity, described above. 

In the thoracic cavity, the segments of the spinal 
cord which produce vasoconstrictor influences, are above 
those centers which produce the vasodilator influences. 
For example, we would produce vasoconstrictor influ- 
ences on the heart from the upper thoracic, as, for 
example, we would produce vasoconstrictor influences by 



Nerve Supply to Abdominal Viscera. 249 

adjustment of the second thoracic vertebra, or by per- 
cussion over the seventh cervical vertebrae, while we 
produce vasodilation by adjustment of or percussion over 
the lower thoracic vertebrae. 

When we pass below central place, or the sixth 
thoracic, we find a different relative arrangement of the 
vasomotor and vasoconstrictor centers influencing the 
viscera supplied. We find that the constrictor centers, 
instead of being located above the vasodilator centers 
as in the arrangement of the nerve supply to the viscera 
of the thoracic region, are situated below the centers, 
which induce vasodilation. This will be brought out as 
we study the influence of the spinal segments relative 
to their action upon the viscera supplied in the abdominal 
cavity. 

Nerve Supply to the Stomach. — The nerve supply 
to the stomach comes from, and is influenced by nerves 
from several different segments and portions of the 
spinal column. We will enumerate below the nerves that 
directly or indirectly supply and influence the stomach 
and impingements affecting the integrity of nerve supply 
to it: 

1. Phrenic. 

2. Pneumogastric. 

3. Upper cervical. 

4. Middle cervical. 

5. Middle thoracic. 

6. Lower thoracic. 

7. The upper lumbar. 

In the above enumeration we see that the nerve 
supply of the stomach comes from both the cervical and 
thoracic segments of the spinal cord, we have also a 
nerve supply from the lower thoracic region direct, 
through the afferent fibers of the pneumogastric and the 
consequent reflex influence. 

The pneumogastric or vagus is quite an important 



2ND. C . V 



4th. c. v. A 




NERVE SUPPLY OF THE STOMACH 



Nerve Supply to Abdominal Viscera. 251 

factor in the nerve supply to the stomach. In mentioning 
the portions of the spinal cord that influence the stomach, 
we include those portions that also influence the vagus 
nerve. The vagus nerve itself is not a matter of important 
consideration in spinal treatment, except as we influence 
or stimulate it directly in the cervical or other regions. 

We have a direct influence upon the stomach by the 
nerve supply furnished through the splanchnic nerves, 
which enter into the formation of the solar plexus and 
other gray rami from the abdominal division of the 
gangliated cords of the sympathetic. This portion of 
the sympathetic enters directly into the nerve supply of 
all the viscera of the abdominal cavity, therefore in this 
connection we wish to investigate the spinal segments 
that influence the functional activity of the abdominal 
viscera in general, or that influence the sympathetic 
ganglia which furnish the nerve supply to the different 
viscera. 

Upper Cervical Nerves. — The upper cervical nerves 
do not themselves directly ramify any of the viscera of the 
abdominal cavity, except they influence them indirectly 
by sending anastomotic branches into the pneumogastric. 
By means of this connection, the vital activity and 
integrity of the pneumogastric nerves are materially 
affected; therefore lesions affecting the integrity of the 
upper cervical nerves, will also affect the functional 
action of the pneumogastrics which exercise a direct 
influence upon the viscera of the abdominal cavity. 

Middle Cervical Nerves. — The fourth pair of 
cervical nerves, together with an auxiliary branch from 
the third and fifth pair of cervical nerves, form the 
phrenic nerves on either side, which enter into the forma- 
tion of the solar plexus after supplying the pericardium, 
pleuras, and diaphragm. 

The lower terminal fibers of the phrenic nerves ramify 
the adrenal ganglia. Because of the connection with the 



252 Nerve Supply. 

phrenic nerve with the above and with the solar plexus, 
interference with the integrity of the middle cervical 
nerve influences, to a limited extent, the functional 
activity of the supra-renal capsules and the stomach. 

Middle Thokacic Nerves. — From the middle tho- 
racic nerves we have our most direct nerve supply to the 
thoracic cavity. These nerves affect the stomach through 
the influence they exert upon the solar plexus, and also 
these nerves directly supply the terminal ganglia of the 
stomach. 

The most direct and potent influence upon the 
stomach seems to form the fifth pair of thoracic nerves 
and from the left side, but we may discover a decided 
influence on the stomach from the fifth down to and 
including the eighth pair of thoracic nerves. 

Most of our stomach troubles are readily relieved by 
adjustment to relieve interference with the fifth and sixth 
thoracic pairs of nerves. The nerve supply to the stomach, 
as we will notice, is from the central segments of the 
thoracic region. From this region, reflex excitations 
originating within and coming from stomach irritations, 
produce decided influences upon the central nervous 
system because of their proximity to the central place 
of the spinal cord. 

The contents of the stomach will often excite inco- 
ordinate reflex phenomena under certain conditions. 
Children who eat food which disturbs the stomach, are 
apt to be thrown into general spasms or convulsions. 

Lower Thoracic Nerves. — We notice another very 
interesting arrangement as to the source of the nerve 
supply exciting the different phases of the vasomotor 
effects upon the abdominal viscera. 

Adjustment of the twelfth thoracic produces a vaso- 
dilator influence upon the stomach, while percussion over 
the ninth thoracic vertebrae will stimulate the origin of 



Nerve Supply to Abdominal Viscera. 253 

the motor nerves that excite the vasodilator influence 
upon the stomach and adjacent viscera. 

Lumbar Nerves. — We find that percussion over the 
first and second lumbar will produce a vasoconstrictor 
effect upon the stomach. Now in this arrangement we 
have the reverse of that which we noticed in the supply 
of the thoracic viscera. Here we have our vasodilator 
centers situated in a higher segment than are the centers 
giving off the vasoconstrictor nerve supply. 

There is this similarity, though, about the arrange- 
ment of the vasoconstrictor and vasodilator centers in 
these different regions. In both regions we find that the 
vasodilator influences are more nearly the central portion 
of the thoracic segments of the spinal cord, while the 
centers supplying the vasoconstrictor nerve supply are 
more distant from the central segments of the spinal 
column. 

We also have an influence acting directly upon the 
stomach by way of the pneumogastric nerves, but in 
such cases the impulses come from the lumbar region 
below. This is because of an intermingling and com- 
munication of the lumbar nerves with the terminal 
filaments of the pneumogastric in the hypogastric or 
pelvic plexus. 

Because of this connection, we have pelvic disturb- 
ances exciting certain influences upon the stomach. For 
example: In gestation we frequently have nausea and 
vomiting. 

Nerve Supply to the Liver. — The nerve supply to 
the liver in many respects is similar to the nerve supply 
of the stomach. Practically the influences exerted upon 
the stomach from the different segments of the spinal 
cord, are duplicated in the phenomena witnessed upon 
the action of the liver. We might enumerate the nerves 
entering into and supplying directly and indirectly the 
liver, as follows: 




NERVE SUPPLY OF THE LIVER 



Nerve Supply to Abdominal Viscera. 255 

1. Phrenic. 

2. Pneumogastric. 

3. Upper cervical. 

4. Middle cervical. 

5. Middle thoracic. 

6. Lower thoracic. 

7. The upper lumbar. 

The Pneumogastric. — The influence upon the liver 
by the pneumogastric is effected by its connections with 
the upper cervical nerves, the result being very much 
the same as the effect upon the stomach. 

The Phrenic Nerve. — Lesions of the middle cervical 
region will interfere with the phrenic nerves, and conse- 
quently excite a direct influence upon the liver. 

Middle Thoracic Nerves. — In the middle thoracic 
nerves, we have quite a different arrangement of the 
nerve supply to the stomach and liver, as follows: 

The stomach receives its nerve supply almost wholly 
from the left side of the spinal column, while the liver 
receives its nerve supply from the right side of the spinal 
column. As the two organs are situated approximate, 
and about in the same level, the nerve supply is from 
practically the same regions, we may expect to witness 
some derangement of the liver from any agency affecting 
the integrity of the spinal nerves on the right side, from 
the fifth or sixth down to and including the eighth. 

The splanchnic nerves have a direct influence upon 
the liver. Percussion over the first and second lumbar 
spinous processes will excite a vasoconstrictor influence 
upon the liver and adjacent organs. 

Upper Lumbar Nerves. — Adjustment of the fourth 
and fifth lumbar vertebrae would influence the same 
nerves as are influenced by percussion over the first and 
second lumbar, but not in the same way. By relieving 
the fourth and fifth nerve by adjustment, we establish 
the normal flow of physiological impulses, but by per- 



256 Nerve Supply. 

cussion over the first and second lumbar we produce or 
incite a very greatly increased activity of the same nerves. 
Lumbar nerves affect the stomach and liver through the 
afferent terminal branches of the pneumogastrics. 

Nerve Supply to the Spleen. — The spleen, stomach 
and liver are closely associated, consequently the different 
segments of the spinal cord that influence the stomach 
and liver, affect in the same way the spleen. The spleen, 
then, will be influenced by lesions in the following regions 
in the spinal column, which are the same as the one 
named above: 

1. Phrenic. 

2. Pneumogastric. 

3. Upper cervical. 

4. Middle cervical. 

5. Middle thoracic. 

6. Lower thoracic. 

7. The upper lumbar. 

The influence of the middle and upper cervical por- 
tions of the spinal column affects the spleen through the 
phrenic and pneumogastric nerves in the same way as 
the liver and stomach are affected. 

The most direct supply to the spleen is from the sixth 
segment of the spinal cord by way of the sixth thoracic 
pair of nerves and through the nerve from the left side. 

Vasodilator influences are exerted upon the spleen 
through stimulation over the lower vertebrae of the 
thoracic region, from about the ninth to the eleventh, or 
by adjusting of the upper lumbar. 

Vasoconstrictor influences are excited by percussion 
over the first and second lumbar, or they are permitted 
by adjustment of the lower lumbar. 

The vasomotor influences upon the spleen are exerted 
in the same way and from the same regions of the spine 
as are the vasomotor effects upon the stomach and upon 
the liver, the only difference between the liver and the 




NERVE SUPPLY OF THE SPLEEN 



258 Nerve Supply. 

spleen being that the spleen receives its nerve supply 
from the left side or left spinal nerve, and from a less 
number of segments of the spinal cord, while the liver 
receives its nerve supply from the right side, but more 
spinal segments contribute nerves to its supply. 

Nerve Supply to Pancreas and Adrenals. — These 
organs receive their principal nerve supply from the 
splanchnic nerves and from terminal plexuses given off 
from the solar plexus. The phrenic and pneumogastric 
nerves from the cervical and cranial regions join the 
solar plexus, but the direct nerve supply affecting these 
organs is from the lower thoracic region. We may 
enumerate the nerves that supply the pancreas and 
adrenals as follows: 

I. Phrenic. 
II. Pneumogastric. 

III. Eighth thoracic nerves. 

IV. Ninth thoracic nerves. 

The eighth pair of thoracic nerves join the sixth pair 
of thoracic nerves on the left side of the spine to form a 
plexus which supplies the spleen and pancreas. 

The eighth thoracic nerves on the right side enter 
most directly into that portion of this plexus which 
supplies the pancreas. 

The illustration represents the eighth thoracic nerve 
making its exit below the eighth thoracic vertebra and 
supplying both the suprarenal capsules and pancreas, 
but the eighth thoracic nerves do not materially affect 
the suprarenal capsule. 

The ninth thoracic nerves, on either side, have a 
most direct and positive influence upon the adrenals, 
and in these organs the fibers of the ninth pair of thoracic 
nerves join the terminal branches of the phrenic nerves 
and they reflexly affect the fourth pair of cervical nerves 
and consequently the organs which they supply. 




NERVE SUPPLY OF THE PANCREAS 
AND SUPRARENAL CAPSULES. 



260 Nerve Supply. 

Nerve Supply to the Kidneys. — The nerve supply 
to the kidneys is from: 

1. Phrenics. 

2. Pneumogastric. 

3. Lower thoracic. 

4. Lower thoracic ganglia. 

5. Least splanchnic nerves. 

The integrity of the functional activity of the renal 
organs is affected by lesions of the spinal column inter- 
fering with the exit of nerves in the following regions: 

1. Upper cervical. 

2. Middle cervical. 

3. The lower thoracic. 

The supply by way of the pneumogastric is the same 
as to the stomach, liver, and spleen. 

The supply from the middle cervical region of the 
spinal cord is through the phrenic nerves. The phrenic 
nerves, however, give their terminal fibers to the supra- 
renal capsules of the kidneys, and for this reason the 
phrenics affect only the adrenals. 

The lower thoracic nerves, from the ninth to the 
twelfth pair, inclusive, affect the kidneys, but the 
more direct effect of spinal nerves is through the tenth 
pair of thoracic nerves. 

The twelfth pair of thoracic nerves send white rami 
into, and form the third, or least splanchnic, and also 
directly affect the renal terminal ganglia of the solar 
plexus. 

The kidneys are situated on both sides of the lower 
abdominal cavity and for this reason interference with 
the integrity of the nerves from either side supplying 
the kidney region, will affect the functional activity of 
the kidneys. 

From the above we can see that, through the connec- 
tion of the lower thoracic nerves with the phrenic nerve, 
the kidneys may renexly affect respiration, and also 




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NERVE SUPPLY OF THE KIDNEYS 



262 Nerve Supply. 

through the phrenic nerves and through the pneumo- 
gastric nerves, kidney lesions may reflexly affect the 
functions of the heart. We often have associated with 
kidney trouble certain cardiac derangements, which is no 
doubt due to the nerve connections between the lower 
thoracic vertebrae and the phrenic and pneumogastric 
nerves. Eye troubles associated with kidney disease are 
because of the nerve connections between the phrenic 
and lower thoracic. 

Nerve Supply to the Small Intestines. — The nerve 
supply to the small intestines is from the following sources : 

1. Phrenics. 

2. Pneumogas tries. 

3. Great splanchnics. 

4. Least splanchnics. 

5. Lesser splanchnics. 

6. The upper lumbar nerves. 

7. Thoracic rami communicantes. 

The special spinal lesions that may interfere with 
the integrity of the nerve supply to the small intestines 
may be in any of the following portions of the spinal 
column: 

, 1. Upper cervical. 

2. Middle cervical. 

3. Lower six thoracic. „ 

4. Upper two lumbar nerves. 

Spinal lesions in the upper portion of the cervical 
region will interfere with the pneumogas tries, while spinal 
lesions in the middle cervical region will interfere with 
the phrenics, and their terminal fibers extend as low as 
the suprarenal capsules of the kidney. 

The lower six thoracic nerves enter into the formation 
of the splanchnic nerves. The great splanchnic nerves 
come from the fifth or sixth down to and including the 
ninth thoracic ganglia and spinal nerves, and therefore 



NERVE SUPPLY OF THE 
SMALL INTESTINE. 



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264 Nerve Supply. 

the great splanchnic supplies the greater portion of the 
small intestines. 

The lesser splanchnic nerves come from the tenth and 
eleventh pairs of thoracic ganglia, and they also supply 
a portion of the intestines and peritoneum, while the 
least splanchnic nerves come from the twelfth thoracic 
ganglia and supply the lower portion of the small intes- 
tines. 

The lumbar nerves exert some influence upon the 
functional activity of the small intestines. Percussion 
of the upper lumbar will excite vasoconstrictor influences 
upon the vascular supply, and vasomotor influences upon 
the muscular walls of the small intestines. 

Nerve Supply to the Large Intestines. — The large 
intestines may be influenced by lesions in the following 
locations: 

1. Pneumogastric. 

2. Upper lumbar nerves. 

3. Lower thoracic nerves. 

4. Lower thoracic ganglia. 

5. Great splanchnic nerves. 

6. Least splanchnic nerves. 

7. Lesser splanchnic nerves. 

Spinal lesions involving the integrity of the nerve 
supply to intestines are as follows: 

1. Upper cervical. 

2. The upper lumbar. 

3. The lower thoracic. 

The following nerves influence the action of the colon: 

1. Pneumogastric. 

2. Great splanchnic. 

3. Lesser splanchnic. 

4. The least splanchnic. 

5. Lower thoracic nerves. 

6. Lower thoracic ganglia. 

7. The upper lumbar nerves. 



NERVE SUPPLY OF THE 
LARGE INTESTINE 




266 Nerve Supply. 

The large intestine, or colon, is influenced most 
directly through the impulses of the second pair of lumbar 
nerves. Vasomotor and vasoconstrictor influences pass 
over the efferent fibers of the second lumbar to the large 
intestines. 

Most cases of diarrhea and dysentery are directly 
influenced and controlled by a second lumbar adjustment. 

The lower thoracic ganglia and spinal nerves influence 
the colon through the splanchnic nerves, and by means 
of the downward stream of white rami which join the 
hypogastric plexus. 

The Appendix. — The nerve supply to the appendix 
would not be much different from that of the colon. We 
find that the second lumbar nerves are involved, in all 
cases of appendicitis. The condition of the appendix 
depends, it seems, almost wholly upon the integrity of 
the second lumbar pair of nerves. In cases of appendi- 
citis in the active or inflammatory stage, we will always 
find the second lumbar nerves tender on the right side, 
and sometimes we find that tenderness extends to the 
left side also. 

We find by experience that by relieving the contrac- 
tion of the musculature of this segment of the spine, that 
we produce an almost instant effect upon the appendix. 
Appendicitis is usually relieved, even in aggravated cases, 
in which there is much inflammation and derangement, 
in a few minutes' time, and recovery ensues very rapidly 
in ninety cases in a hundred. We fully believe that nine 
cases out of ten of appendicitis may be permanently 
relieved by a single thrust to remove interference with 
the second lumbar nerve on the right side. 

Nerve Supply to the Peritoneum. — The nerve 
supply to the peritoneum is almost identical with the 
nerve supply to the large and small intestines, being 
directly supplied by the pneumogastric nerves from 



Nerve Supply to Abdominal Viscera. 267 

above, and also in the upper portion by the phrenic 
nerves. 

The peritoneum is also supplied by the great, lesser, 
and least splanchnics, and by white rami from the lower 
thoracic and upper lumbar spinal nerves. 

The peritoneum is known to be able to take care of 
a considerable quantity of septic materials when it is 
the recipient of the normal physiological nerve impulses 
originating in the spinal cord and brain. A stimulation 
of the spinal centers will greatly enhance or increase this 
power of autoproteetion of the peritoneum. If stimu- 
lation of the spinal centers were practiced in cases of 
peritonitis, this trouble would soon be considered but a 
trivial ailment, and easily conquered. 

In all infectious diseases of the peritoneum, we 
reflexly get interference with the spinal nerve supply to 
the peritoneum. If we relieve that reflex contraction 
and stimulate the nerve centers to action, we would 
readily induce that efficient autoproteetion that would 
prevent the development and spread of any infectious 
disease from one portion of the peritoneum to another. 

Probably the most frequent involvement of the 
peritoneum is in the lower portion thereof, and the 
adjustment that will usually relieve peritonitis will be 
in the lower portion of the thoracic, down to and including 
the second lumbar segment of the spine. 



CHAPTER IV. 
NERVE SUPPLY TO PELVIC VISCERA. 

THE nerve supply to the pelvic viscera is of sympa- 
thetic and cerebro-spinal origin. That part of the 
sympathetic system that contributes to the supply 
of the pelvic viscera is the hypogastric and inferior 
hypogastric plexuses, or what is sometimes termed the 
pelvic plexus. The spinal nerves which contribute to 
the supply of the pelvic viscera are: 

1. Pneumogastric. 

2. Sacral nerves. 

3. Lumbar nerves. 

4. Lower thoracic. 

In addition thereto, the first and second cervicals 
exert an influence upon the pelvic viscera because of 
their communicating branches to the pneumogastric 
nerves. The terminal branches of the pneumogastric 
join the hypogastric plexus and terminate in the pelvic 
plexus. 

There are two peculiar features of the nerve supply 
to the pelvic viscera. One is that of the pneumogastric 
nerves because of their long continuation down through 
all of the viscera of the entire trunk, all of which they 
help supply or influence in a measure. 

The other peculiar feature is, that the downward 
stream of white rami from the lower thoracic segments 
of the spine, join the gangliated cords of the sympathetic 
and pass down and enter into the formation of the pelvic 
plexus, and consequently into the supply of the pelvic 
viscera. 

A portion of the nerve supply affecting the vitality 
and functioning of the pelvic viscera is peculiar in that, 
in the sacral region, the nerves are given off through 

268 



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NERVE SUPPLY OF 
THE UTERUS. 



270 Nerve Supply. 

solid bony foramina; consequently there is no chance 
for sacral nerves to become involved because of impinge- 
ment produced by spinal contractions. However, any 
lesions affecting the integrity of the nourishment of the 
spinal cord in any of the regions above, will materially 
interfere with the integrity of the sacral nerve supply 
to the pelvic organs. 

Nerve Supply to the Uterus. — The uterus is sup- 
plied principally by the uterine plexus, which is a terminal 
plexus of the sympathetic system, and also receives 
branches from the third and fourth sacral nerves. The 
hypogastric plexus and the vesical plexus also contribute 
to the uterine supply. 

The uterine and hypogastric plexuses are materially 
influenced by the lower thoracic nerves, whose connec- 
tion with these plexuses is by way of the downward 
stream of white rami communicantes, and these terminal 
ganglia are also materially affected by the lower lumbar, 
which communicates with them directly without passing 
into the gangliated cords of the sympathetic. 

The principal vasomotor influences are excited by a 
stimulation of the fourth pair of lumbar nerves ; however, 
there is some excitation of the hypogastric plexus by a 
stimulation of the first to the fourth lumbar nerves 
inclusive. 

Adjustments to relieve the fourth lumbar nerves have 
a most decided effect upon the vascular system and 
muscular walls of the uterus. Lesions involving the 
integrity of the fourth lumbar are productive of mal- 
function, vasodilation, and prolapsus of the uterus and 
addenda. 

Nerve Supply to the Bladder. — The nerve supply 
to the bladder is similar to the uterus, in that it receives 
its supply from both the sympathetic and cerebro-spinal 
nerves. It receives its sympathetic supply from the 
pelvic plexus of the sympathetic system, and receives its 




NERVE SUPPLY OF THE 
BLADDER. 



272 Nerve Supply. 

spinai nerve supply from the third and fourth sacral 
pairs of spinal nerves. 

The bladder is especially affected by the lower thoracic 
and upper lumbar nerves, through the terminal plexus 
that supplies the bladder. 

Stimulation of the tenth segment of the spinal column 
will cause an increase of the vasomotor and vasoconstrictor 
impulses to the bladder. An adjustment relieving any 
contractions or any interference with the first pair of 
lumbar nerves where they make their exit from the 
neural canal, has a very positive and curative effect 
upon cystitis. Some very stubborn, chronic cases of 
cystitis have recovered in a comparatively short time 
after the restoration of the integrity of the first pair of 
lumbar nerves, which was accomplished by an adjust- 
ment of the articulation between the first and second 
lumbar vertebrae. 

We believe that in the majority of cases of cystitis, 
that this treatment will be very successful, and that an 
absolute cure without this measure in chronic cases, is 
almost, if not an impossibility. 

We find almost uniformly that it is the first pair of 
lumbar nerves that has the most positive and decided 
influence upon the bladder. 

Nerve Supply to the Prostates. — The prostate 
receives its nerve supply from both the sympathetic and 
cerebro-spinal division of the nervous system. 

The hypogastric plexus of the sympathetic seems to 
supply most of the direct rami to the prostate glands. 

The lower thoracic spinal nerves have a direct influ- 
ence upon the hypogastric plexus, which supplies the 
prostate glands. 

The sacral nerves also directly supply the prostate 
glands, but the lesions that most materially affect the 
prostate glands seem to be the third lumbar. In the 
treatment of prostatic troubles, then, we should remember 



Nerve Supply to Pelvic Viscera. 273 

both the lower thoracic and lower lumbar nerves — more 
especially the latter. 

Nerve Supply to the Ovaries and Testicles. — 
The ovaries are supplied by branches of the sympathetic, 
and by branches of the cerebro-spinal division of the 
nervous system. 

The sympathetic supply for the ovaries and testicles 
is a plexus, which in the female is known as the ovarian 
plexus, an offspring of the renal plexus, and a continuation 
of the renal plexus along the ovarian artery. 

The aortic plexus also gives off communicating rami 
which ramify the ovaries. 

The spinal centers that affect the ovaries and testicles 
are situated at about the third lumbar segment of the 
spinal cord, while the nerves that have the most decided 
influence upon the ovaries and testicles come from the 
third lumbar pair of spinal nerves, which make their 
exit between the third and fourth lumbar vertebrae. 

If there is no interference with the third pair of lumbar 
nerves, the chances are that the functioning of the 
ovaries and testicles will be normal unless branches 
supplying them more indirectly influence them adversely. 

The sacral nerves contribute to the supply of these 
organs, as do the lower thoracic, which contribute the 
white rami communicantes to the downward stream that 
joins and supplies the terminal ganglia given off from the 
pelvic plexus. 

Nerve Supply to the Inguinal Canal. — The nerves 
supplying the inguinal canals come off from the anterior 
crural nerves, which are made up of branches from the 
second, third and fourth lumbar nerves and branches 
from the lumbar plexuses. 

In cases of interference with lumbar nerves, we are 
liable to have an atonic condition of the musculature of 
the inguinal canal. The relaxed condition induced 
thereby, associated with the relaxed condition of the 



NERVE SUPPLY OF THE OVARY 
AND FALLOPIAN TUBES. 




Nerve Supply to Pelvic Viscera. 275 

mesentery permitting a prolapse of the bowels, tends to 
permit hernia and protrusion. 

The removal of interference with the nerve supply is 
the best preventive, as well as the best relief for hernia. 
The second lumbar nerves seem to affect most materially 
the musculature of the inguinal canal, and for that 
reason we usually find an involvement of the second pair 
of lumbar spinal nerves in connection with all cases of 
hernia. Therefore, we usually excite and stimulate the 
second pair of lumbar nerves in cases of hernia and often 
the results are indeed surprising. 

Percussion in the region of the eleventh and twelfth 
dorsal segments of the spinal column will stimulate the 
nerve supply to the inguinal canal. Cases of hernia of 
long standing often respond readily to a stimulation of 
the second pair of lumbar nerves by percussion over the 
roots of the efferent fibers, and also these cases have been 
relieved by relieving all interference with and by restoring 
the integrity of the second pair of lumbar nerves. 

Nerve Supply to Rectum. — The nerve supply to 
the rectum is from the sympathetic, and also from the 
cerebro-spinal division of the nervous system. 

Branches are given to the rectum from the mesenteric 
plexus, from the sacral plexus, and from the hypogastric 
plexus. The spinal nerves to the rectum come directly 
from the third, fourth, and fifth sacral nerves, which 
supply motor and sensor roots, but the spinal nerves 
that affect the rectum, and that may become impinged 
because of contractions affecting the foramina between 
movable vertebrae, originate about the fourth or fifth 
lumbar segments of the spinal column, so that stimula- 
tion by percussion over the twelfth dorsal vertebrae has 
a vasomotor and stimulating effect upon the nerve supply 
to the rectum. 

A thrust given to the spinous process of the fourth 
and fifth, and more especially the fifth vertebra, will 




NERVE SUPPLY OF THE RECTUM 



Nerve Supply to Pelvic Viscera. 277 

relieve the principal spinal nerve supply, affecting the 
rectum. This nerve supply, though, is not direct, but 
the result of white rami from the fourth and fifth — more 
especially the fifth pair of lumbar nerves, which join the 
terminal ganglia of the pelvic plexus which supply the 
rectum. 

By some it is claimed that the centers of micturition, 
defecation, and parturition, are contained within the 
second lumbar segment of the spinal cord. 

Nerve Supply to the Genitalia. — The nerve supply 
to the genital organs is from both the sympathetic and 
cerebro-spinal system, and is supplied by the sympa- 
thetic from the pelvic plexus and the terminal ganglia 
given off therefrom, and the spinal nerve supply is from 
the lower thoracic, lumbar, and sacral regions. 

The lower thoracic contribute influences to all the 
pelvic organs, including the genital organs, by means of 
the downward stream of white rami communicantes. The 
more direct spinal nerve supply is from the lumbar and 
sacral regions. 

As sacral nerves cannot be interfered with, we find 
the principal effect that we produce upon the genital 
organs, as well as all other pelvic organs, is by stimula- 
tion or adjustment to relieve interference with the lumbar 
nerves. 

The second pair of lumbar nerves excite a vasomotor 
and stimulating effect upon the erectile tissues of the 
genitalia. The third and fourth lumbar nerves also have 
a direct and positive effect, and it is claimed that relief 
of the fourth pair of nerves will relieve the nerves that 
come from the genital centers of the spinal cord. 



CHAPTER V. 
CEREBROSPINAL CENTERS. 

THERE are certain parts or centers in the brain, 
and certain segments in the spinal cord, that 
seem to be a dividing point, or a center, so to 
speak, because of the anatomical arrangement of the 
nerves originating therefrom or because of the divergence 
of the nerves in their ramifications. 

We will only refer, in this connection, to those spinal 
centers that are most clearly marked, or the more promi- 
nent and manifest centers of the spine, and will also 
mention those special initials or names that are recog- 
nized as applying to certain segments of the spinal 
column, or to certain vertebrae thereof, and will also 
state briefly why they are so denominated. 

In the brain there is no decidedly distinct center or 
division existing, yet we find in the ramification of the 
twelve pair of cranial nerves a slight demarcation or 
difference existing in the distribution of the first eight 
and the last four. The first eight of the twelve pair of 
cranial nerves are distributed directly and wholly to the 
organs of the head and face, as follows: 

First pair to the Schneiderian membrane of the nose. 

Second pair to the retina of the eye. 

Third pair to the muscles of the eye. 

Fourth pair to one muscle of the eye. 

Fifth pair to the teeth, tongue, and face. 

Sixth pair to the superior oblique of eye. 

Seventh pair to the ear, palate, tongue, face. 

Eighth pair to the internal ear, acoustic nerves. 

None of the above seem to ramify any portion of 
the cervical region, except a few nerve fibers from the 
fifth and seventh facial nerves, consequently the first 

278 



Cerebrospinal Centers. 279 

eight pair are peculiar in this, that they are distributed 
almost entirely to the head, or different parts of the 
organs of the head and face. 

Now, passing from the first eight pair of the cranial 
nerves, we come to cranial nerves that ramify regions 
outside of the head; in fact, in some cases going into the 
lower portion of the trunk. The glosso-pharyngeal 
nerves do not extend very low, but they ramify portions 
of the cervical region and send branches to the tonsils, 
but the tenth is entirely different, in that its ramifications 
are almost wholly downward through the cavities of the 
trunk extending into the pelvic region. 

The spinal accessory pair of cranial nerves, and also 
the twelfth pair, ramify portions of the neck, and thus 
classify with the ones above, and differentiate in this 
matter from the first eight. This makes a minor dividing 
line, then, between the first eight pair and the last four 
pair of cranial nerves, but it is not of great importance 
in treatment, but more of a marked anatomical feature. 

In the cervical region we have eight pair of spinal 
nerves. We have also in the cervical region a clear point 
of demarcation because of the difference of the ramifi- 
cation of the lower cervical and the upper cervical pairs 
of nerves. The upper four pair of cervical nerves, by a 
union of their primary anterior branches, enter into the 
formation of the cervical plexus, and the branches of the 
cervical plexus are distributed largely to the upper 
cervical regions of the neck and the side of the face and 
scalp. 

The lower four pair of nerves of the cervical region 
unite in the formation of the brachial plexus, and their 
branches of distribution tend to pass downward over the 
chest and outward into the upper extremities. We have 
branches from the brachial plexus that supply the front 
and back portions of the chest, and branches that run as 
far down on the side of the chest as the lower side of the 



280 Nerve Supply. 

serratus magnus muscle, or to the lower border of the 
ninth ribs. 

The other branches of the brachial plexus, however, 
pass into the upper extremities. This peculiarity of the 
arrangement of distribution of the lower four cervical 
nerves, makes a decided difference and a distinct dividing 
line between the lower four and the upper four cervical 
nerves. 

There is, however, one important or apparent devia- 
tion of this division of the upper and lower cervical 
nerves in that the fourth pair seem to affect decidedly 
the teeth, the gums, and the pupils of the eyes. They 
give off the phrenic nerves, which pass down to and 
supply the pleuras, pericardium, and diaphragm, and 
also send branches of ramification and supply viscera 
down as far as the supra-renal capsules of the kidneys. 

The line of demarcation which is manifest between 
the distribution of the upper four and the lower four 
cervical pairs of nerves, is of some importance in diagnosis, 
or in locating the spinal lesions affecting the chest and 
upper extremities, and also those lesions which affect 
the head and cranial organs. 

The connection of the upper cervical nerves with the 
terminal ganglia of the sympathetic, and the fact that 
they are distributed almost wholly to these ganglia, 
shed much light on the way in which we affect the 
organs of the head by upper cervical adjustment, and 
how, by relieving interference with upper cervical nerves, 
we will restore normal function to different organs of 
the head region. It is remarkable the effect we may have 
upon the hearing, sight, teeth, gums, nasal cavity, scalp, 
and face, by removing all interference with the spinal 
nerve supply to them. 

In the thoracic region we have a clearly marked center 
that is very important from the standpoint of both 
diagnosis and treatment, and also from the anatomical 



Cerebrospinal Centers. 281 

differences in the arrangement, distribution, and ramifi- 
cation of the rami communicantes. 

Let us recall for a moment that the spinal column is 
the first portion of the nervous system that is formed in 
embryonic development. Second, the brain is really a 
growth on to the upper end of the spinal cord, and the 
lower nerves to the lower extremities are a continuation 
of the extension of the spinal nerves downward. Also, 
in the development of the fetus, the viscera of the trunk 
are first assembled, or begin to be developed in the central 
region of the future trunk, and as the fetus reaches a 
more perfect development, these organs tend to move 
toward their permanent location which they occupy in 
the fully developed child. Now, the central point from 
which all viscera gravitate in the trunk, becomes at once 
a most important center. 

Now the question is, where is this center located? 
What is central place in the thoracic cavity? There are 
a number of anatomical facts that furnish us a key to 
the location, and there are differences in the distribution 
of nerves that mark the location of central place, and 
mark central place so clearly that we cannot make a 
mistake, unless we are unconscious of the points of 
demarcation. 

The first thing that marks the location of central place 
in the thoracic region, to which we call your attention, 
is the point of the division between the two streams of 
the white rami communicantes which join the gangliated 
cords of the sympathetic division of the nervous system. 
Down to, and including the fifth pair of spinal nerves, 
and some fibers from the sixth, we have white rami 
communicantes that join the gangliated cords of the 
sympathetic, and the tendency of these white rami after 
doing so, is to form an upward stream by sending some 
of their fibers upward. 

Not all of these fibers, however, pass up as noted in 



282 Nerve Supply. 

a previous chapter, as some of the white rami fibers pass 
directly through the ganglia where they join in the 
gangliated cord to the terminal ganglia, while other 
fibers arborize around the ganglionic cells in that portion 
of the cords, where they join them. 

Another division of the white rami pass via the com- 
missural portion of the gangliated cords up to, and termi- 
nate in the superior cervical ganglia of the sympathetic. 

Now we have from the lower six thoracic nerves, 
white rami communicantes, which join the gangliated 
cords of the sympathetic, forming a downward stream of 
white rami communicantes. These behave somewhat 
similar to the white rami forming the upward stream, 
in that all the fibers do not pass downward, but only a 
portion of them. This marks clearly and unmistakably 
the location of central place at the sixth segment of the 
spinal cord, or at the point of exit of the sixth pair of 
nerves of the thoracic region. 

Another indication of the division that exists, is the 
plan of the formation of the cardiac and solar plexus. 
The upper five pair of thoracic nerves, and branches 
from the sixth pair of thoracic nerves, enter into the 
formation of the cardiac plexus, while from the sixth 
down to, and including the twelfth, the white rami com- 
municantes passing through the gangliated cords, join in 
the formation of the epigastric or solar plexus. This 
point also marks clearly and unmistakably the location 
of central place at the sixth thoracic segment, or at the 
sixth pair of thoracic nerves. 

Peripheral markings of the division existing between 
the upper and lower thoracic nerves, which markings also 
show that central place is at the sixth segment, are as 
clear, pointed, and unmistakable as are the internal 
variations. 

The upper six pair of thoracic nerves supply, and 
are wholly distributed to the walls of the thoracic cavity, 



Cerebrospinal Centers. 283 

while the lower six are distributed partly to intercostal 
spaces, and partly to the walls of the abdominal cavity. 

Again, the internal branches of the upper six inter- 
costal nerves are distributed to the skin, while their 
external branches are distributed to the muscles. In 
the lower thoracic region, we have the reverse of this 
arrangement, in that we have the external branches of 
the intercostal nerves supplying the skin, while the 
internal branches are distributed to the muscles. 

There is still another anatomical difference or line of 
demarcation between the upper and lower six inter- 
costal nerves in the location of their branches, as follows: 

The upper six intercostal nerve branches are located, 
or pass between the pleura and the intercostal muscles, 
while the lower six are situated between the skin and the 
abdominal muscles. 

The above difference marks the anatomical location 
of central place clearly and distinctly, and the sixth 
dorsal segment is the only place at which we may locate 
central place, as it is the location of the dividing point 
between the anatomical features that we have just 
mentioned. 

This is one of the most important centers of the ner- 
vous system. It is not only important from the stand- 
point of diagnosis and the standpoint of treatment by 
adjustment, but is especially important from the stand- 
point of treatment in case we wish to stimulate the motor 
centers affecting the organ of the cavity of the trunk, as 
the arrangement each way from the central place is 
reversed with reference to the location of the vasodilator 
and vasoconstrictor centers. 

In the lower part of the thoracic nerves, we have a 
subcenter, so to speak, but it is also quite an important 
center. We notice by stimulation of the spinal nerves 
that we will induce perspiration, and further we notice 
this peculiarity, that, when we make an adjustment above 



284 Nerve Supply. 

the tenth thoracic, the perspiration is stimulated 
from that segment of the adjustment upward. Below 
the tenth we find stimulation of the spinal nerves affect 
the activity of the skin below point of thrust. 

The dividing point between these differences in skin 
action, is at the tenth thoracic segment of the spinal 
column. A stimulation of the tenth segment increases 
or influences the action of the skin of the entire body. 
We find this fact laid down by some of our phys- 
iologists and find that the writers thereof have located 
the central place for skin action at the tenth thoracic. 
This is an important point, and one that should be 
remembered in the treatment of all skin troubles. 

If we wish to increase the action of the elimination 
of both the skin and the kidneys, an adjustment of the 
tenth thoracic for the stimulation of this pair of nerves 
will prove effective in most cases. 

Percussion over the sixth or seventh cervical verte- 
brae would stimulate to a still greater action the centers 
that give rise to the nerves that we influence by an adjust- 
ment of the tenth thoracic. 

Now, of the above centers we have mentioned, they 
are all important, save the one division mentioned, of 
the cranial nerves. 

From the fourth cervical nerve we have such a direct 
action upon the circulation of the thoracic cavity upon 
the organs of the head; and from the sixth we have a 
decided action upon the entire central nervous system. 
I have been enabled to stop some cases of chorea and 
St. Vitus dance by a single thrust, because of the influence 
of the sixth pair of thoracic nerves upon the central 
nervous system. 



CHAPTER VI. 
CEREBRO-SPINAL CENTERS. 

FOR convenience and for brevity and because of an 
established custom among certain practitioners 
of spinal adjustment, we will outline an initial 
nomenclature used to indicate the different spinal 
vertebrae or vertebral processes. 

There is an air of professional competency denoted 
by the use of such a system of identification which is 
somewhat superior to calling spinal vertebras by number. 

We cannot fully agree with the nomenclature that 
has formerly been used by some educators in this line of 
work, and for this reason we' have made some significant 
changes, but only where it seemed that such a change 
was urgently demanded by the anatomical facts in the 
case. 

We hope that some uniform initials of identification 
may be agreed upon and adopted by all the teachers and 
practitioners of spinal adjustment methods. 

We will now enumerate the initials that are usually 
applied to the different vertebras of the spinal column, 
as used by those who practice spinal adjustment or 
chiropractic spondylotherapy, as far as we can endorse 
the nomenclature that has been applied: 

At. P. . Atlas Place. — The first cervical pair of 
nerves as they are relieved by atlas adjustment, have 
been denominated atlas place. 

C. C. P. Central Cervical Place. — The fourth 
pair of cervical nerves are considered the dividing point, 
or central place, of the cervical nerves. This is because 
of the peculiarity of the ramification in which this fourth 
pair of nerves are distributed — partly upward similar to 
the upper four cervical nerves, and other fibers downward 

285 



286 Nerve Supply. 

similar to the lower four cervical nerves. It is therefore 
called the central cervical place. 

L. C. P. Lower Cervical Place. — The lower 
cervical nerves embracing those from the fifth, down to 
and including the eighth, are called the lower cervical 
places. 

A. P. Arm Place. — Owing to the fact that the first 
thoracic nerves give off very large anterior primary 
branches of ramification that go into the formation of 
the brachial plexuses in connection with the lower 
cervical nerves, and as they have so much to do with 
the general nerve supply of the arms, the first thoracic 
vertebra has been denominated arm place. 

The first pair of thoracic nerves in their ramification, 
are different from the other upper thoracic nerves, in 
that the anterior branches .containing most of the fibers 
of these nerves pass into the brachial plexuses, while 
the intercostal nerves are very small branches of the 
first pair of thoracic nerves. 

The second pair of thoracic nerves are divided in 
the same way, but there is a less amount of their fibers 
that go into the formation of the brachial plexuses. 
They, however, give off the in tercos to-humeral nerves, 
which join with the brachial plexuses and send branches 
into the arms. We often relieve pain and functional 
derangement of the upper extremities by adjustment of 
the second thoracic vertebra. 

U. H. P. Upper Heart Place. — The second thoracic 
pair of nerves, or second thoracic segment of the spinal 
column, has been called upper heart place, for the reason 
that it has a more important effect and a more decided 
influence than any pair of nerves above this region. 

A stimulation of the second pair of thoracic nerves 
may produce a very decided vasomotor stimulation and 
vasoconstriction action affecting the heart. We relieve 
interference with the vasoconstrictor influences by having 



Cerebrospinal Centers. 287 

the second pair of thoracic nerves made free from inter- 
ference. If we wish to intensify the vasomotor and vaso- 
constrictor influences upon the heart, we may do so by 
stimulating the roots of origin of the second pair of 
thoracic nerves. This may be done by percussion over 
the spinous or transverse processes of the seventh cervical 
vertebra. This is a very important auxiliary treatment 
in case of thoracic or abdominal aneurism or in case of 
dilatation of the heart or general vasodilation. 

The second pair of thoracic nerves also have a very 
important influence upon the bronchial tubes, and relief 
of interference with these nerves is a specific for bronchial 
coughs, which is due to the extensive ramification of 
the bronchial tubes by the second pair of thoracic nerves. 

Lg. P. Lung Place. — The third pair of thoracic 
nerves have been denominated lung place, because of 
the fact that they ramify the upper part of the chest, 
and give the principal supply to the pleura of the lungs 
and also to the apexes thereof; all of the upper portion 
of the lungs is ramified and principally supplied by the 
third pair of thoracic nerves. 

It seems that the reason why the third pair of thoracic 
nerves have so much to do with the supply of the pleura 
and the lungs, is because of their origin being in close 
proximity to the roots of the lungs, and to that portion 
of the pleura which receives the principal nerve supply. 
We know by experience that these nerves ramify the 
pleuras to their lowest extremities. We have been able 
to relieve pleurisy in almost every case by relieving the 
third pair of thoracic nerves. 

The writer calls to mind a case of pleurisy that had 
been diagnosed as gall stones. The case was sent from 
Indiana to Oklahoma, hoping that the change of water 
and climate might give some relief from the constant 
suffering from the passage of gall stones. Climatic 
influences, however, had but little or no effect upon 



288 Nerve Supply. 

this case, and subsequently the patient contemplated 
undergoing an operation for the removal of gall stones. 

Before the operation was performed, and while 
arrangements were being made, a friend of the lady 
brought her to the writer for an examination. Upon 
examination, we found no trouble with the nerve supply 
to the liver, and said without a doubt and without 
hesitancy that there was no trouble with the gall bladder, 
and no gall stones. Further examination elicited the 
fact that the third thoracic nerve on the right side was 
very tender and sensitive, whereupon a diagnosis of 
pleurisy was made. 

An inquiry into the history of the case substantiated 
the indications of the spinal lesions. Treatment was 
given, which consisted of a thrust to the third thoracic 
spinous process, and absolute relief was given. One 
week's treatment was sufficient to overcome all of the 
symptoms, and no subsequent attack has returned. This 
case had suffered with pleurisy for five years since an 
attack of pneumonia. A general vasoconstrictor influence 
may be obtained by percussion over the spinous pro- 
cesses of the fourth and fifth cervical vertebras, while 
vasodilation is produced by percussion over the spinous 
processes of the fifth to the eighth thoracic vertebrae. 
Percussion over the spinous process of the seventh 
cervical vertebra will cause vasomotor stimulation of 
the lungs. 

H. P. Heart Place. — The fourth thoracic pair of 
spinal nerves which are given off from the fourth spinal 
segment of the spinal cord, is known as heart place. 

This is due to the fact that the fourth pair of thoracic 
nerves affect very materially the muscular walls of the 
heart, and induce an inhibitory control of the heart's 
action, as well as stimulating the vasomotor and myo- 
motor action of the heart. 

We find that by removing interference with the fourth 



Cerebrospinal Centers. 289 

pair of nerves, that we have a very decided effect upon 
the heart. Persons who have ceased to breathe and whose 
hearts have ceased to beat during anaesthesia from 
chloroform, have been brought back to life by a thrust 
relieving and stimulating the fourth pair of thoracic nerves. 

Percussion over the first and second thoracic spinous 
processes will have a similar inhibitory effect upon the 
heart's action. This is because of the fact that the fourth 
segment of the spinal column is more nearly directly 
within the neural canal under the first and second thoracic 
vertebrae. Now, for the above reason, in case of heart 
failure, we may intensify the effect of our treatment by 
a thrust to relieve interference with the fourth pair of 
thoracic nerves, followed by percussion over the seventh 
cervical, or over the first and second thoracic spinous 
processes. 

S. P. Stomach Place. — The fifth thoracic spinous 
process or vertebra has been called stomach place, not 
because the fifth pair of thoracic nerves are the only 
ones that enter into the nerve supply of the stomach, 
but because usually the nerves from the left side of the 
spine, from this segment, seem to influence and most 
decidedly stimulate the action of the stomach. 

The left nerves from the fifth thoracic segment pass 
into the superior and cardiac end of the stomach; hence 
have most to do with the functioning of that organ. The 
sixth, seventh, and even the eighth pair, also contribute 
to the nerve supply that influence the stomach, but as 
we go below central place and stimulate nerve centers, 
we begin to have a vasodilator influence upon the stomach 
instead of a vasoconstrictor, as we do through the fifth 
pair of nerves. 

The stomach is situated within the upper part of 
the abdominal cavity, and is consequently supplied by 
the solar plexus. There is one peculiarity concerning 
the nerve supply to the stomach and that is the fifth 



290 Nerve Supply. 

thoracic nerve on the left side has so much to do with 
the nerve supply to the. stomach. The fifth thoracic 
nerves on the right side send their branches upward to 
the throat and organs of the head, on the left side, into 
the cardiac or thoracic cavity. Vasomotor stimulation 
of the stomach may be produced by percussion over the 
spinous process of the second thoracic vertebra. 

C. P. Central Place. — This is one of the most 
important segments of the entire spinal column, and has 
the most decided and positive effect upon the general 
nervous system. This pair of nerves not only supply 
the organs adjacent to their ramification, but the organs 
of the entire body are influenced by the general effect 
upon the nervous system through stimulation of the 
sixth segment of the spinal cord, or by freeing the sixth 
pair of thoracic nerves. 

The most direct influence upon the spleen is also 
through the sixth pair of thoracic nerves, and also the 
sixth pair often have a most positive influence upon the 
stomach. The most positive stimulating effect upon the 
central nervous system may be obtained by percussion 
over the spinous processes of the second and third 
thoracic vertebrae. 

L. P. Liver Place. — The seventh pair of thoracic 
nerves and the seventh segment of the spinal cord have 
been called liver place, because of the fact that the 
seventh pair of nerves enter more fully into the supply 
of the liver than any other pair, and influence the liver 
in fact more than any other. 

The liver is a large organ, however, and receives 
branches from several different pairs of spinal nerves; 
but being located entirely on the right side it is only 
supplied from the right side of the neural canal. The 
sixth, seventh, and eighth furnish the principal supply 
to the liver. Percussion of the segment of the spine 
under the tip of the spinous process of the fourth thoracic 



Cerebrospinal Centers. 291 

vertebrae will cause stimulation of the nerve supply to 
the liver. 

P. P. Pancreatic Place. — The eighth thoracic seg- 
ment may be called pancreatic place for this reason: 
From the eighth pair of thoracic nerves on the left side, 
and from the sixth pair of thoracic nerves, is formed a 
plexus that seems to almost wholly supply both the 
spleen and pancreas. 

The spleen is above, and is influenced more by the 
sixth pair of nerves, while the pancreas is below, and 
influenced more by the eighth pair of spinal nerves; 
hence we denominate the eighth pair of spinal nerves as 
pancreatic place, notwithstanding that they have a 
material influence upon the upper portion of the small 
intestines. Percussion to stimulate the segments of the 
cord from which originate these nerves will cause dilation 
of the lungs because of the connection and influence of 
these nerves upon the terminal ganglia of the phrenic 
nerves. 

Ad. P. Adrenal Place. — The ninth thoracic pair 
of spinal nerves supply the supra-renal capsules of the 
kidneys, and for this reason may be called upper kidney 
place, or adrenal place, and we have chosen the latter 
nomenclature. 

K. P. Kidney Place. — The tenth thoracic vertebra 
is called kidney place, for the reason that the tenth pair 
of nerves seem to have the most direct and positive 
influence upon the kidney action. 

In addition to the branches given off from the tenth 
pair of spinal nerves, we have the renal plexuses, which 
are formed from the twelfth thoracic pair of nerves, so 
the tenth thoracic pair of nerves are not by any means 
the only nerves influencing the kidneys. 

U. B. P. Upper Bowel Place. — The eleventh 
thoracic we denominate upper bowel place, for the 
reason that the eleventh pair of thoracic nerves materially 



292 Nerve Supply. 

influence the small intestines as well as the kidneys. This 
is also true of the twelfth pair of thoracic nerves. Both 
the eleventh and twelfth thoracic segments may be 
denominated bowel place. They both enter into the 
formation of the solar plexus, and both have to do with 
the direct nerve supply to the major portion of the 
small intestines. 

L. K. P. Lower Kidney Place. — The twelfth 
thoracic vertebra and the twelfth thoracic pair of nerves 
we denominate the lower kidney place, because of their 
influence upon the kidneys, for the reason that from 
this pair of nerves are given off branches forming the 
renal plexus. The twelfth pair of thoracic nerves also 
affect the bladder. This seems to be because of the 
downward stream of the white communicantes. 

B. P. Bladder Place. (First lumbar vertebra.)— 
There is no pair of spinal nerves that seems to have a 
more positive stimulation and vasomotor effect upon the 
bladder than the first lumbar pair, and there are no 
nerves that are so uniformly responsible for the functions 
of the bladder as are the first lumbar pair of nerves. 

L. B. P. Lower Bowel Place. — The second lumbar 
vertebra, so called because of the decided influence of 
the second pair of lumbar nerves upon the large 
intestines. The second lumbar nerves are very important 
for the reason that they supply the appendix and inguinal 
canal, influencing the large and small intestines, but have 
been called genital place because of the vasomotor effect 
upon the erectile tissues of the genital organs. 

O. P. or T. P. Ovarian or Testicle Place. — The 
third pair of lumbar nerves are so called because of their 
direct influence upon the ovaries of the female, and they 
also supply the testicles of the male. 

L. G. P. Lower Genital Place. — The fourth lum- 
bar pair of spinal nerves are so called because they are 
derived from that segment of the spinal cord containing 



Cerebrospinal Centers. 



293 



the genital centers, and further, because of their direct 
influence upon the uterus, especially vasomotor effects 
upon this organ. 

The fourth pair of nerves also influence and help to 
supply the rectum. 

R. P. Rectal Place. — The fifth pair of lumbar 
nerves are supplied most directly to the rectum, and it 
is this pair of nerves that may become involved because 
of spinal lesions. For this reason, the fifth lumbar 
vertebra has been denominated rectal place. 

Now in the above we have enumerated, as far as we 
could, the initials that are commonly used by practi- 
tioners of chiropractic spondylotherapy, and are only 
sorry that we could not conform to their nomenclature 
throughout, but we fully believe that the above nomen- 
clature is more correct. 

Again, we should remember in all spondylotherapy 
methods, that in treating the centers above, or relieving 
the nerves above mentioned, that we are only relieving 
the principal nerve supply to the organ or the viscus in 
question, as all of these organs receive a nerve supply, 
or are influenced by the ramification of nerves from 
different segments of the spinal column. 

For your convenience, we enumerate below the 
names and initials that have been indicated above, as 
follows : 



1st Cervical 


A. P. 






Atlas Place 


2d Cervical 


Ax. r 


> 




Axis Place 


3rd Cervical 


IT. C. 


c. 


p. 


Upper Central Cer- 
vical Place 


4th Cervical 


C, C. 


p. 




Central Cervical 
Place 


5th Cervical 


L. C. 


c. 


p. 


Lower Central Cer- 
vical Place 


6 th Cervical 


L. C. 


p. 




Lower Cervical 
Place 



294 





Nerve 


Supply. 


7th Cervical 


U. A. P. 


Upper Arm Place 


1st Thoracic 


A. P. 


Arm Place 


2d Thoracic 


U. H. P. 


Upper Heart Place 


3rd Thoracic 


Lg.P. 


Lung Place 


4th Thoracic 


H. P. 


Heart Place 


5th Thoracic 


S. P. 


Stomach Place 


6th Thoracic 


C. P. 


Central Place 


7th Thoracic 


L. P. 


Liver Place 


8th Thoracic 


P. P. 


Pancreatic Place 


9th Thoracic 


Ad. P. 


Adrenal Place 


10th Thoracic 


K. P. 


Kidney Place 


11th Thoracic 


U. B. P. 


Upper Bowel Place 


12 th Thoracic 


L. K. P. 


Lower Kidney Place 


1st Lumbar 


B. P. 


Bladder Place 


2d Lumbar 


L. B. P. 


Lower Bowel Place 


3rd Lumbar 


0. P. 


Ovarian Place 


4th Lumbar 


G. P. 


Genital Place 


5 th Lumbar 


R. P. 


Rectal Place 



CHAPTER VII. 
SPINAL CENTERS. 

IN this chapter, we wish to consider briefly the different 
segments of the spinal column from the standpoint 

of their influence upon the different viscera of the 
body when stimulated by spinal concussion for thera- 
peutic purposes. 

Now in our study of the function of nerves, we find 
that they have a myomotor influence that affects the 
musculature of the entire body. 

We find, by a study of the vasomotor influence of the 
nervous system upon the musculature system, that the 
vasomotor nerves exert both a vasodilator and a vaso- 
constrictor influence upon the heart and vascular system. 

Nerve action of any kind may be increased by stimu- 
lation, and one of our best and most effective methods of 
nerve stimulation is that of concussion, if properly applied 
over the different segments of the spinal cord. 

We may increase the myomotor action of any portion 
of the body or any viscera contained therein by concussion 
and stimulation of the special spinal centers from which 
originate the nerve supplying the zone or part we desire 
to affect. 

We may affect vasoconstriction in case of congestion, 
aneurism or dilation of the heart, but, in order to do so, 
we should understand and use the best and most effective 
methods of stimulation and also the conditions under 
which such treatment should be given. 

The efferent nerves may be best and most power- 
fully stimulated by the application of the stimulant to 
their central ends of origin in the spinal cord or brain. 
The efferent nerves are especially prepared, as to excit- 
ability, for the reception of impulse at their central origin. 

295 



296 Nerve Supply. 

It is true that an efferent nerve may be stimulated 
at its point of exit from the neural canal or at any point 
of its pathway of distribution, but stimulation of an 
efferent nerve at its central origin where it is prepared 
for the reception of impulse, produces the maximum 
result in the increase of impulse generation and trans- 
mission, and also the maximum amount of work done 
by the nerve so stimulated, provided it is not hindered 
in its power of conductivity by impingement. 

The conductivity of a nerve is liable to be depreciated 
by an interference with that nerve at its point of exit 
from the neural canal either by impingement or by the 
occlusion of the nutrient supply. 

A nerve that is stimulated at its central origin may 
fail to induce normal functional activity in any organ 
or part of the body because of structural lesions of the 
zone supplied, or because of retention of the by-products 
of muscular activity or of imperfect digestion and deposits 
of uric acid and urates into the cellular structures. 

For the above reasons it is necessary that we have 
perfect freedom of efferent nerves from any interference 
of any nature in their power of production and trans- 
mission of impulse, and it is necessary that the histo- 
logical or structural condition of the zones supplied by the 
nerves stimulated be in a normal condition that normal 
function may be produced. 

If a nerve center is interfered with so that it lacks 
the power of excitability and initiation of impulse or 
the nerve is impinged so that the power of conductivity 
is diminished, it is necessary to remove such interference 
that we may experience the full result of the stimulation 
which we induce by concussion or by other methods of 
stimulation. It is also necessary to assist in many 
cases the dissolution and elimination of the effects and 
by-product matters accumulated as the result of retention. 

In this chapter we wish to call attention to the 






Spinal Centers. 297 

influence of nerves upon the organs they supply and 
affect. We wish to call special attention to the effects 
of concussion of certain vertebrae or segments of the 
spine, upon certain internal organs or parts of the body. 
We will of necessity be brief and will especially call 
attention to those who are interested in this excellent 
auxiliary method of spondylotherapy to the book 
Spondylotherapy by Dr. Albert Abrams which is devoted 
especially to this subject. 

Upper Cervical Nerves. — These nerves supply 
communicating branches to the terminal ganglia of the 
upper cervical and cranial regions. First by adjustment 
of this region we remove all interference with the upper 
cervical nerves, and by so doing we restore their normal 
conductivity, and a free transmission of the normal 
physiological impulses, which are or should be trans- 
mitted by them. In this way we relieve pain in the 
parts they supply and affect, causing toothache, earache, 
tic douloureux, etc. 

Now if we wish to increase the amount of impulse 
which is transmitted to above the normal we may do 
so by concussion applied to either the spinous or over 
the transverse processes of a vertebra. Concussion over 
the upper two cervical vertebrae affects the brain and 
almost every organ in the cavities of the trunk. It is best 
to apply the concussion to the laminae of the cervical 
vertebrae. By concussion of the atlas ■ and axis we 
affect the recurrent meningeal nerves which are formed 
partly by branches of the first and second cervical pair 
of nerves. We also stimulate the pneumogastric through 
stimulation of the first and second cervical nerves which 
send communicating branches into the pneumogastric 
nerves. 

From the above Ave see how we may stimulate the 
brain and also the heart, lungs, and stomach, by affecting 
the recurrent meningeal and pneumogastric nerves. 



298 Nerve Supply. 

Stimulation of the upper cervical nerves will produce a 
decided effect upon the eyes, ears, and the brain. 

Middle Cervical Nerves. — Concussion over the 
origin of the fourth and fifth cervical nerves will exert 
a special stimulating effect upon the phrenic nerves. 
Concussion over the third cervical accelerates the action 
of the heart. Concussion over the fourth and fifth cervical 
also excites the myomotor action of the heart and a 
vasoconstrictor influence upon the lungs. Concussion in 
the middle cervical region will resuscitate a patient in 
case of sudden heart failure and is a useful measure in 
cases of fainting. Adjustment or concussion affecting 
the first and second cervical nerves is also a useful 
method in resuscitation because of the influence of the 
communicating branches of these nerves upon the pneu- 
mogastric. 

Lower Cervical Vertebra. — In concussion of the 
lower cervical segments we affect the upper thoracic 
nerves for the reason that the centers of origin of the 
upper thoracic nerves are situated in the spinal segments 
which are in the neural arches of the lower cervical 
vertebrae. 

Concussion over the spinous or transverse process of 
the seventh cervical vertebra stimulates the origin of 
the second pair of thoracic nerves. The center of origin 
of this pair of nerves is one of our most important spinal 
centers because of the general effect exercised upon the 
vasomotor system. Concussion over the seventh cervical 
vertebra causes myomotor action of the heart muscles. 
Vasomotor and vasoconstrictor effects upon the heart 
aorta and blood vessels generally. Seventh cervical 
concussion is especially recommended for aneurism, 
dilation of the blood vessels in goiter or in congestion of 
the eyes, ears, or viscera, or thoracic or abdominal cavity 
because of the vasomotor and vasoconstrictor action that 
is thus induced. 



Spinal Centers. 299 

Concussion over the seventh cervical vertebra will also 
restore to life in cases of recent heart failure, and this 
method has long been used by the Japanese. 

Concussion over the first and second thoracic vertebrae 
especially stimulates the fourth pair of thoracic nerves. 
They furnish myomotor and vasoconstrictor action of 
the heart muscles and exert an inhibitory influence 
upon the heart's action. 

Patients who have suddenly become unconscious and 
in whom the heart has ceased to beat, from chloroform 
or sudden heart failure, may have the heart's action 
restored by a fourth thoracic adjustment, which will 
relieve and stimulate the fourth pair of thoracic nerves 
or they may be restored by concussion over the first and 
second thoracic. When a person is restored by or through 
stimulation of the fourth pair of thoracic nerves the 
heart's action will be strong and full but slow, seldom 
above normal because of the inhibitory influence of this 
pair of nerves. 

Concussion of the first and second thoracic vertebrae 
then will strengthen and inhibit the heart's action by 
affecting the fourth pair of thoracic nerves. 

Third to Eighth Dorsal. — The third to eighth 
dorsal vertebrae contain in their neural arches the centers 
of origin of all the thoracic nerves from the fifth or sixth 
down to and including the twelfth pair of thoracic nerves. 
The fifth to the twelfth pair of thoracic nerves enter 
into the formation of the splanchnic nerves and they 
also join the lower seven thoracic ganglia to the ganglia ted 
cords which enter into the formation of the splanchnic 
nerves. 

Concussion over the third to eighth dorsal vertebrae 
then will stimulate the splanchnic nerves which control 
the vascularity and muscular tonicity of the abdominal 
viscera. 

Concussion over this region of the spinal column 



300 Nerve Supply. 

excites especially the splanchnic reflex of vasoconstriction 
and will relieve intra-abdominal congestion and at the 
same time increase the congestion or vascularity of the 
thoracic cavity and viscera. The increase of the blood 
supply of the lungs from concussion of the middle thoracic 
vertebra seems to be due largely to the vasoconstrictor 
influence of the splanchnic nerves upon the abdominal 
viscera, and the consequent increase of blood forced into 
the thoracic cavity. 

Fifth Dorsal. — Concussion elicits contraction of 
pylorus. 

Fourth Dorsal. — Concussion stimulates seventh 
segment of spinal column, elicits contraction of gall 
bladder, dilates pylorus, contracts pancreas and supra- 
renal capsules. 

Sixth, Seventh, and Eighth Thoracic. — Elicits 
kidney reflex of contraction. 

Eighth to Twelfth Thoracic Vertebrae. — Concus- 
sion over the eighth to twelfth thoracic vertebrae affects 
the lumbar nerves and renexly affects the pneumogastric 
nerves whose terminal filaments communicate with the 
lumbar nerves in the hypogastric plexus. Concussion over 
the vertebrae of this region aff eets dilation of the abdominal 
viscera and also of the heart. In a case of constriction 
of the liver, constriction of the stomach or constipation 
from bowel constriction, concussion of the tenth, eleventh 
and twelfth, more especially the eleventh thoracic, is 
especially indicated. 

Ninth Thoracic — Concussion stimulates first lum- 
bar segment, distends gall bladder, stimulates bladder, 
affects anaemia, chlorosis, Bright' s disease, and locomotor 
ataxia. 

Concussion over the spinous process of the twelfth 
thoracic vertebra while exciting a dilatory influence 
over the abdominal cavity at the same time causes 
vasoconstriction and contraction of the pelvic organs. 



Spinal Centers. 301 

Concussion of the twelfth thoracic elicits reflex of con- 
striction and stimulation of the bladder and prostate. 

First, Second, and Third Lumbar. — Concussion 
over this region affects the central origin of the sacral 
nerves and the spinal exit of the upper lumbar nerves. 
Their influence seems to be that of vasoconstriction of 
the abdominal organs, and also of the pelvic organs. 

Adjustment of the second lumbar affects vasocon- 
striction of the lower bowels. Concussion over the 
same vertebra seems to produce the same effect as 
adjustment, which seems to be due to the stimulation of 
the second pair of lumbar nerves at their special exit by 
either adjustment or concussion. 

Concussion over this vertebra is especially useful 
in congestion of the liver, spleen, stomach, intestines, and 
uterus. 

Fourth and Fifth Lumbar Vertebra. — Concussion 
over the fifth lumbar vertebrae produces vasoconstrictor 
influences upon the pelvic organs, and this is especially 
marked in the treatment of the bladder and reetum. 

In concluding the above remarks concerning the 
influence of the different centers we especially urge a 
careful study of the relation of the spinal exit of nerves 
to their centers of origin, and also urge that adjustment 
that will relieve all interference with nerves, should be 
given to insure freedom of the transmission of the 
physiological impulses so that stimulation by concussion 
may have the maximum results. 

Relief of all contractions of the spine interfering with 
the exit of the spinal nerves will remove pain in every 
case. Stimulation of spinal nerves by concussion over 
their points of origin will increase the impulse generated 
and transmitted, and elimination will insure perfect 
results from nerve impluse in the /one we desire to affect. 



PART FOUR. 

SPONDYLO-SYMPTOMATOLOGY. 

CHAPTER I. 

THE NORMAL SPINE. 

THE normal spinal column is from two feet to two 
feet four inches in length; consists of twenty-four 
movable vertebrae (which are called vertebrae 
from the word "vertero," which means to turn) and other 
tissues as follows: 

Besides the bony segments or vertebrae, the spinal 
column consists of intervertebral cartilages, ligaments, 
tendons, and muscular tissues, and there is contained in 
the neural canal, the spinal cord, lymphatics, and blood 
vessels; and within the tissues of the spine, terminal 
nerve endings and a capillary system, and there is 
attached to the thoracic portion of the spinal column 
on either side, twelve pairs of ribs. 

The true vertebrae of the spine are divided as follows: 

1. Seven cervical vertebrae. 

2. Twelve dorsal vertebrae. 

3. Five lumbar vertebrae. 

The length of the spinal column in the different 
regions is approximately as follows: 

1. Cervical region, 5 inches. 

2. Dorsal region, 11 inches. 

3. Lumbar region, 7 inches. 

In addition to the above, we have what may be 
termed, a part of the spinal column, consisting of original 
five sacral vertebrae and four coccygeal vertebrae. These 
in adult life are anchylosed. Before fusion of these 
bones, we have thirty-three segments in the spinal cord, 
including both the true and the false vertebrae. After 

303 



301 



Spondylo-symptomatology . 



anchylosis we have twenty-six vertebrae, twenty-four 
being movable; the other two, sacral and coccygeal, 
formed of nine original vertebrae, constitute the two false 
or immovable vertebrae. 




Illustration showing a normal and an abnormal spine, and the effects of 
lesions of the spine upon the intervertebral foramina. 



The spine, normally, has an anterior curvature in the 
cervical region, beginning with the axis, and extending 



The Normal Spine. 305 

to the second or third thoracic spinous process ; a posterior 
curvature in the thoracic region, extending from the 
second thoracic to the tenth spinous process of the tenth 
thoracic, and an anterior curvature in the lumbar region, 
beginning with the spinous process at about the tenth 
thoracic vertebrae, and ending with the lumbo-sacral 
articulation. Each vertebrae consists of the following: 

1. One centrum. 

2. Two pedicles. 

3. Two laminae. 

4. One spinous process. 

5. Four articular processes. 

6. Two transverse processes. 

7. Two articular surfaces of centrum. 

The pedicles and laminae, together with the centrum, 
form the neural arch of each vertebrae, and the consecutive 
neural arches form the neural canal, which contains the 
spinal cord, and protects it from injury. 

The neural canal varies in size and shape in different 
portions of the spinal column. 

It is triangular in shape, and is largest in the upper 
cervical region. 

The neural canal is nearly round, and is the smallest 
in the thoracic region. 

It increases in size below, so that the lumbar neural 
canal is larger than the thoracic portion of the neural 
canal, but is smaller than the cervical. The lumbar 
neural canal is triangular in shape. 

The discs between the vertebrae vary in thickness in 
the different regions of the spine. The thinnest inter- 
vertebral cartilage is between the third and seventh 
thoracic vertebrae; the thickest intervertebral cartilage 
is between the lumbar vertebrae. 

The anterior common ligament is the largest, strongest 
and longest of the spinal column. It covers the bodies 
of the vertebrae in front — and it is this ligament that 



306 Spondylo-symptomatologij. 

gives great strength to the spine, and enables beasts of 
burden to carry their heavy loads upon their backs. 

We also have the posterior common ligament that 
covers the back portion of the spinal vertebrae, and lines 
the front of the neural canal. 

We have accessory ligaments between the laminae, 
and between the transverse and spinous processes. 

The spinal cord is from 16 to 18 inches in length, and 
terminates on a level with the lower border of the first 
lumbar vertebra. 

1. The spine, because of its flexuous contour, and 
because of the elasticity of the intervertebral discs, 
protects from the effects of jars or shocks. 

2. The spine is the central pillar and support of the 
weight of the trunk and head. 

3. The spinal vertebrae furnish attachments for the 
ribs and for the erector muscles of the spine, which 
support the spine in its upright attitude. 

4. The spinal column furnishes a canal for the passage 
and protection of the spinal cord from the brain to the 
lower end of the spine. 

5. The spine is a flexible and nexuous column, and 
is susceptible to many varieties of movements. The 
principal movements of the spine are: 

1. Flexion. 

2. Rotation. 

3. Extension. 

4. Lateral rotation. 

5. Compound movements. 

These movements are more free in the cervical than 
in any other region, and the flexibility and rotation of 
the spine varies considerably in different persons, and 
decidedly in different forms of life. 



The Normal Spine. 



307 



HOW TO DETERMINE THE LOCATION OF THE 
SPINOUS PROCESS OF A VERTEBRA. 



1st Cervical Atlas. 



2nd Cervical Spine. 
3rd Cervical Spine. 

4th Cervical Spine. 



5th Cervical Spine. 
6th Cervical Spine. 



7th Cervical Spine. 
(Vertebra Prominens. 



1st Thoracic Spine. 



LANDMARKS. 

The atlas has no spinous process. 
The location, of the posterior 
arch of the atlas is midway 
between the occipital bone and 
the first spinous prominence. 

Best recognized as the first spinous 
process palpated below occipi- 
tal bone. 

Difficult to palpate. It is covered 
under the large heavy process 
of the axis, except when the 
neck is flexed. 

This is the second spinous process 
that is palpated below the 
occipital bone when the neck 
is in normal position, and the 
third that is palpated when the 
neck is flexed. 

This is the first spinous process 
below that of the fourth cer- 
vical vertebra. 

This is the second spinous process 
below that of the fourth, and 
the first above that of the 
seventh cervical vertebra. 

This is distinguished by the promi- 
) nence of its length, and serves 
as a guide for counting pro- 
cesses above and below. 

This is on a level with the superior 
portion of the spine of the 



308 



Spondyto-symptomatotogy . 



2nd Thoracic Spine. 
3rd Thoracic Spine. 

4th Thoracic Spine. 

5th Thoracic Spine. 
6th Thoracic Spine. 
7th Thoracic Spine. 



8th Thoracic Spine. 
9th Thoracic Spine. 
10th Thoracic Spine. 



scapula, and may be detected 
by placing thumbs on a line 
with the fingers above the 
spines of the scapula on both 
sides. 

This may be best determined by 
palpating the one below the 
first thoracic spine. 

Corresponds to the inner edge of 
the spine of the scapula, and is 
the second process palpated 
below the first spinous process. 

This is best located by counting 
from the first process above, 
or from the seventh below. 

This is best located by counting 
from the seventh below. 

This is best located by counting 
from the seventh below. 

This is on a line with the inferior 
angles of the scapula when the 
patient is standing, and a fin- 
ger's breadth above when the 
patient lies prone with the 
arms hanging. Locate by plac- 
ing thumb on a line between 
finger just below scapulae on 
each side. 

This may be best located by first 
locating the seventh thoracic 
process. 

This may be best located by first 
locating the seventh thoracic 
process. 

This is a finger's breadth below 
the attachment of the last 



The Normal Spine. 



309 



11th Thoracic Spine. 

12th Thoracic Spine. 
1st Lumbar Spine. 

2nd Lumbar Spine. 

3rd Lumbar Spine. 

4th Lumbar Spine. 



5th Lumbar Spine. 



true rib, and may be detected 
by the prominence of the tenth 
pair of ribs in the axillary line 
by following them to the spine. 

This may be located by counting 
from the seventh spinous pro- 
cess above, or tenth above. 

This may be located in the same 
way as the eleventh. 

This is best located by counting 
from the fourth lumbar spinous 
process below. 

This is best located by counting 
from the fourth lumbar spin- 
ous process below. 

This is best located by counting 
from the fourth lumbar spinous 
process below. 

This is on a line with the highest 
point of the crest of the ilium, 
and may be determined by 
palpating the sacrum and the 
fifth lumbar below; or, by 
placing the thumbs on a line 
midway between the fingers 
upon the crest of the ilia on 
both sides. 

This is immediately above the 
sacrum, and below the fourth 
lumbar spine. 



RELATION OF THE EXIT OF SPINAL NERVES TO 
THE SPINAL PROCESSES. 



1st Cervical Nerves. 



Exit on a level with the interspace 
between the spinous process of 
the axis and the osciput. 



310 



Spondylo-symptomatology . 



2nd Cervical Nerves. 
3rd Cervical Nerves. 

4-th Cervical Nerves. 

5th Cervical Nerves. 

6th Cervical Nerves. 

7th Cervical Nerves. 

8th Cervical Nerves. 

1st Thoracic Nerves. 

2nd Thoracic Nerves. 
3rd Thoracic Nerves. 

4th Thoracic Nerves. 



Exit on a level with the center of 

the spinous process of the axis. 
Exit on a level with the spinous 

process of the second cervical 

vertebra. 
Exit on a level with the 

process of the third 

vertebra. 
Exit on a level with the 

process of the fourth 

vertebra. 
Exit on a level with the 

process of the fifth 

vertebra. 
Exit on a level with the 

process of the sixth 

vertebra. 
Exit on a level with the 

process of the seventh cervical 

vertebra. 
Exit on a level with the interspace 

between the spinous process of 

the seventh cervical and first 

thoracic vertebrae. 
Exit on a level with the interspace 

between the spinous process of 

the first and second thoracic. 
Exit on a level with the interspace 

between the spinous process of 

the second and third thoracic 

vertebrae. 
Exit on a level with the spinous 

process of the third thoracic 

vertebra. 



spinous 
cervical 



spinous 
cervical 



spinous 
cervical 



spinous 
cervical 



spinous 






The Normal Spine. 



311 



5th Thoracic Nerves. 



6th Thoracic Nerves. 



7th Thoracic Nerves, 



8th Thoracic Nerves. 



9th Thoracic Nerves. 



10th Thoracic Nerves. 



11th Thoracic Nerves. 



12th Thoracic Nerves. 



1st Lumbar Nerves. 



Lumbar Nerves. 



3rd Lumbar Nerves. 



Exit on a level with, the spinous 

process of the fourth thoracic 

vertebra. 
Exit on a level with the spinous 

process of the fifth thoracic 

vertebra. 
Exit on a level with the spinous 

process of the sixth thoracic 

vertebra. 
Exit on a level with the spinous 

process of the seventh thoracic 

vertebra. 
Exit on a level with the spinous 

process of the eighth thoracic 

vertebra. 
Exit on a level with the spinous 

process of the ninth thoracic 

vertebra. 
Exit on a level with the interspace 

between the spinous process of 

the tenth and eleventh thoracic 

vertebrae. 
Exit on a level with the superior 

border of the spinous process 

of the twelfth thoracic vertebra. 
Exit on a level with the center of 

the tip of the spinous process 

of the first lumbar vertebra. 
Exit on a level with the center of 

the tip of the spinous process 

of the second lumbar vertebra. 
Exit on a level with the center of 

the tip of the spinous process 

of the third lumbar vertebra. 



312 



Spondylo-symptomatology . 



4th Lumbar Nerves. 



5th Lumbar Nerves. 



Exit on a level with the center of 
the tip of the spinous process 
of the fourth lumbar vertebra. 

Exit on a level with the center of 
the tip of the spinous process 
of the fifth lumbar vertebra. 



APPROXIMATE RELATION OF SPINAL SEG- 
MENTS TO THE SPINOUS PROCESSES. 



Spinous Processes. 


Spinal Segments. 


Posterior arch of atlas 


. First cervical 
Second " 


segment 




Spinous process of 2nd cervical. . 


. Third 
Fourth 


i 


i i 
i i 


Spinous process of 3rd cervical . . 


. Fifth 


i 


a 


Spinous process of 4th cervical . . 


. Sixth 


i 


i i. 


Spinous process of 5th cervical . . 


. Seventh 


i 


i i 




Eighth ' 


i 


i i 


Spinous process of 6th cervical . . 


. First thoracic 


segment 




Second 


i i 


t i 


Spinous process of 7th cervical . . 


. Third 


" 


i i 


Spinous process of 1st thoracic. . 


. Fourth 


i i 


i i 


Spinous process of 2nd thoracic. . 


. Fifth 


i i 


1 1 


Spinous process of 3rd thoracic. . 


. Sixth 


i i 


i i 


Spinous process of 4th thoracic. . 


. Seventh 


" 


i i 


Spinous process of 5th thoracic. . 


. Eighth 
Ninth 


i i 


a 


Spinous process of 6th thoracic. . 


. Tenth 


1 1 


" 


Spinous process of 7th thoracic. . 


. Eleventh 


4t 


" 


Spinous process of 8th thoracic. . 


. Twelfth 


i i 


i i 


Spinous process of 9th thoracic. . 


. First lumbar 


segment 


Spinous process of 10th thoracic. 


. Second 


a 


i t 




Third 


i i 


a 


Spinous process of 11th thoracic. 


. Fourth 


i i 


i i 




Fifth 


a 


i i 



The Normal Spine. 313 

Spinous process of 12th thoracic. .First sacral segment 

Second " 
Third " 
Fourth " 
Fifth 

Spinous process of 1st lumbar. . . .Coccygeal segment 



CHAPTER II. 
SPONDYLO-SYMPTOMATOLOGY. 

SPONDYLO-SYMPTOMATOLOGY means spinal 
symptomatology, or spinal symptoms. By this 
term we refer to those indications we find in spinal 
lesions which are discovered by palpation and by inspec- 
tion, and which signify interference with the nerve supply 
to the different organs or parts of the human organism. 

This is an important subject to anyone who would 
intelligently practice the science of spinal treatment. 
First, it is an important auxiliary method of diagnosis, 
especially in that it locates the spinal lesions, which cause 
interference with the nerve supply to the different patho- 
logical zones or viscera; and, also, a knowledge of the 
spinal symptoms and how to discover them, is a necessary 
prerequisite to the proper treatment of spinal lesions for 
the purpose of relieving the nerve supply to any diseased 
part. 

This subject has not been studied carefully as it 
should have been; in fact, has hardly been studied at all, 
except by osteopaths, chiropractors, and practitioners 
of mechano- therapy. 

The gross lesions of the spine, especially such as spinal 
curvature and Potts disease, and other pathological 
lesions of the spine that destroy its conformation, have 
been considered by the general medical profession, but 
it seems they have almost entirely overlooked the more 
common, more important, and more obscure symptoms 
that indicate minor lesions which involve the integrity 
of the nerve supply to the different viscera and organs. 

Sometimes it is difficult to detect all of the symptoms 
of spinal lesions, but in most cases the principal symptoms 
are easily determined by the touch of the trained palpator. 

314 



Spondylo-symptomatology . 315 

We wish to enumerate some of the principal symptoms 
that we elicit by palpation of the spine: 

All nerve force or energy that generates function in 
any part of the body is dependent upon the transmission 
of impulses from the spinal cord to the organs supplied 
direct, or to terminal ganglia of the sympathetic, which 
are responsible for its functional activity. 

Whether an impulse is generated in the brain or in 
the spinal column, or whether an impulse is the result 
of an afferent stimulation, it is always transmitted by 
means of efferent nerves from the spinal column outward 
to the organ or part supplied. This is due to the fact 
that efferent nerves are only prepared for the reception 
of impulses at their central ends, and only transient 
nerve impulse in a centrifugal direction. 

The nerve energy, or nerve force, or the vital energy, 
or vital force, or, what we consider a better name, nerve 
impulse, must all come from the spinal column, and it 
is for this reason that we should give due consideration, 
and study more closely than we ever have, the existence 
of spinal lesions, and symptoms which indicate interfer- 
ence with the integrity of the spinal nerves, at their point 
of exit from the neural canal, consequently with the 
transmission of the nerve impulse. 

We might, without due consideration, decide that the 
spinal nerve sheath could not become involved in such a 
way as to interfere with the nerve supply to an organ. 
We might feel assured, that owing to the ligaments and 
tendons of the spine and their abundance and strength, 
that so perfect a structure and arrangement would be 
proof against vertebral subluxations or malapproximation 
to such an extent as would interfere with the nerves 
making their exit therefrom. We may judge that any 
kind of a subluxation would be absolutely impossible 
owing to the general strength and arrangement of the 
musculature and the bony structures of the spinal column. 



316 S pondylo-symptomatology . 

Many people, when they first hear of osteopathy, 
think it is a fraud, and many think that when the osteo- 
path speaks of vertebral lesions, that he is visionary, but 
by a careful study of the work osteopaths have done, we 
are convinced that there is virtue in their methods, and 
instead of condemning their practice, instead of pre- 
judging and saying there is nothing in their work, we 
should investigate and know wherein the merit of their 
treatment lies. 

Many are outspoken against spinal adjustment as a 
method of treatment, and while they do not pretend to 
speak from experience, or knowledge, or reason, yet, 
notwithstanding the lack of all these, they presume to 
inform the dear people "that there is nothing in such 
treatment." 

"Drugless cures are a fact, and they have come to 
stay. Medicine has been here a long time, and will stay 
until we change our drugs for the leaves of the tree of 
life in the better land." 

When the writer first heard of chiropractic, he 
thought it was a fraud, but by a combination of circum- 
stances he became convinced that there was something 
that could be accomplished by spinal adjustment. After 
investigation, I have been surprised what could be done 
by correcting spinal lesions, but in order to be able to 
correct spinal lesions, it is necessary that we have a 
comprehensive knowledge of them, and of the methods 
of determining them. 

I feel confident that if we were able to relieve all 
spinal interference which may impair the integrity of the 
normal nerve supply, that we will be enabled to restore 
normal function, and also to correct the normal histo- 
logical conditions, especially of the cellular structures 
that have suffered as a result of the derangement of the 
processes of metabolism, provided the alteration is not 



Spondylo-symptomatology. 317 

too great or the waste products of metabolism not too 
abundant. 

In our study of spinal lesions, we are studying them 
with a view of determining the more obscure lesions, and 
after locating them, to relieve the contraction of the 
musculature of the spine that is causing the impingement 
upon the integrity of the normal nerve supply. 

When by inspection of the spine we determine certain 
symptoms or lesions that are very manifest, we may 
see malconformation of the spine in many cases, and we 
may enumerate the different phases of such lesions 
under the following heads: 
I. Torsion. 
II. Settling. 

III. Lordosis. 

IV. Kiphosis. 
V. Scoliosis. 

VI. Malalignment. 
VII. Approximations. 

I. Torsion. — This is a condition in which the spine 
or one or more vertebrae thereof are twisted upon their 
axes. This condition may be manifested by patients 
when walking. They may walk with one shoulder 
apparently ahead of the other, or with one hip ahead of 
the other. Torsion is associated, to a certain extent, 
with scoliosis, and other deviations from the normal 
outlines of the spinal column. 

II. Settling. — A settling of the spine may be 
uniform throughout, or it may be confined to a certain 
region or regions. Uniform settling of the spine will 
come on with age, but the amount of settling in the 
different portions of the spinal column will vary in pro- 
portion to the original thickness of the intervertebral 
cartilage, and in proportion to the superimposed weight 
upon different portions, and in proportion to the effects 
of the contraction of the musculature in special regions. 



318 Spondylo-symptomatology. 

Settling of the spine coming on with age, is also 
proportionate to the habitual fatigue and muscle tire, 
and also proportionate to continued interference with the 
tonicity of the erector muscles of the spine, and also to 
a constant amount of interference with the physiological 
nerve impulses, which maintain the tonicity of the 
erector spinal muscles. 

III. Lordosis. — Lordosis is a forward bending of a 
segment of the spine with reference to adjacent segment 
below and above. 

As the patient stands erect, we have an inward 
anterior bending of the spinal column, and an abnormal 
concavity of the back in a certain portion. 

If the patient lies on a table, then we have an unusual 
and sometimes abrupt downward curvature of a segment 
of the spinal cord. 

Lordosis is more apt to affect the thoracic region, and 
is much more discernible in that region than in any 
other, because of the fact that we have normally a back- 
ward curvature in the thoracic region, while there is a 
forward curvature of the spine in the cervical and lumbar 
regions. 

IV. Kiphosis. — By kiphosis is meant a lesion just 
the reverse of lordosis. It is a backward posterior, or 
outward abnormal curvature of a portion of the spinal 
column, and may affect any portion of the thoracic or 
lumbar regions. It is a condition that we find in connec- 
tion with Potts disease, and also a condition that grows 
or increases in the upper thoracic region of people as age 
comes on. 

V. Scoliosis. — Scoliosis is a lateral condition, or 
lateral curvature of a segment, or of the entire length 
of the spinal column. Often scoliosis is double in its 
effect upon the contour of the spinal column and a 
curvature is then to both sides, forming an outline of the 
spinal column similar to the letter S. 



Spondylo-symptomatology. 319 

In a great many patients we find a long sweeping 
curvature of the spine to the right, extending from the 
top of the thoracic spine, down to the lumbar region. 

VI. Malalignment. — Malalignment of vertebrae is a 
deviation from their normal alignment, and is indicated 
principally by the position of the points of the spinous pro- 
cesses and also by the position of the transverse processes. 

Any contractured condition of the musculature of 
only one side of adjacent vertebrae, will throw the spinous 
processes of the vertebrae affected out of perfect align- 
ment, and many unwittingly think that the vertebra 
has slipped out of its place. Any condition that contracts 
and approximates one side of the spine and contracts 
cartilage of one side between two or more adjacent 
vertebrae, will, if the condition continues a sufficient 
length of time, cause a decrease of the thickness of the 
intervertebral disc or cartilage on the side of the con- 
traction. 

This will produce a condition of malalignment of the 
spinous processes. If the contracture is of the same 
amount on both sides, then there is a uniformity of the 
compression upon the intervertebral cartilages, and a 
general thinning, but there will be no deviation from the 
normal alignment of the spinous processes in the latter 
case. However, there would be a general approximation, 
and consequently an interference with the spinal nerves 
passing from both sides, either directly by impinge- 
ment, or by interfering with the nutrient supply to the 
spinal centers in the spinal column. 

VI. Approximations. — Approximations which are 
local in effect, means a thinning of the cartilages between 
two adjacent vertebrae. This may take place in the 
thoracic or in the lumbar regions, or, in fact, any portion 
of the spine. 

The tendency to contraction on both sides of the 
spine from an afferent irritation, is a natural result of 



320 Spondylo-symptomatology. 

the spreading of the impulse of irritation from one side 
of the cord to the other. 

A continuation of a contracted condition between two 
spinal vertebrae will cause a permanent thinning of the 
intervertebral disc, and consequently with the size of 
the intervertebral foramina. 

We will next call your attention to evidences of spinal 
lesions that we may discern in certain objective and sub- 
jective symptoms: 

I. Contractures. 
II. Tender nerves. 

III. Malalignments. 

IV. Pain, any variety. 
V. Deranged function. 

VI. Specific symptoms. 
VII. Anatomical lesions. 

The above list of evidences of spinal lesions are not 
those which are manifest, as is the former list given, but 
such as may be elicited by an examination of both sub- 
jective and objective symptoms. 

I. Contractures. — A contractured condition is a 
condition of contraction remainder existing in the mus- 
culature of the spinal column. This can usually be 
determined by palpation, and sometimes is sufficiently 
manifest to be discerned by inspection. 

By passing the fingers along down the spine, palpating 
on either side of the spinous processes, you will frequently 
notice that the tissues are absolutely normal for some 
distance, when all of a sudden you discover or palpate a 
segment or portion of the spine where there exists a little 
thickening of the muscles and tendons, or an indurated 
condition which insures us at once, that there is some- 
thing wrong with the musculature of this portion of the 
spine. 

Muscular contraction never occurs except as the 
result of nerve impulse, and when we find excessive 



Spondylo-symptomatology . 



321 



impulses and excessive contractions resulting in contrac- 
tured conditions, we know there is a mechanical irritation 
that is making inroads upon the integrity of the normal 
nerve supply to the muscles of this segment of the spine. 

An increased temperature in any segment of the spinal 
column, is indicative of an inflammatory or an acute 
pathological process in the zone receiving its nerve sup- 
ply from that segment. This symptom is associated 
with acute lesions and acute diseases. 

Any local decrease of temperature of a spinal segment 
indicates a lack of thermogenesis and also the lack of 
other afferent functions of the nerve or nerves from the 
spinal segment so affected. This symptom is associated 
with chronic lesions and paresis. 

Muscular contraction or muscular bands along the 
spinal column are positive signs of interference and 
irritation of the spinal nerves of that portion of the spine. 

Muscular contraction is present in both acute and 
chronic lesions. The indurated muscles associated with 
chronic lesions are peculiar in their characteristics, 
and by this means we may differentiate between acute 
and chronic lesion. 





Illustration showing the exit of the neural sheath. On the left is an 
unimpinged nerve sheath, while on the right is an impinged nerve sheath 
and reduction in size resulting therefrom. 



322 Spondylo-symptomatology. 

Nerves may be irritable, excitable, and acting exces- 
sively because of a partial anaemia or congestion of the 
spinal segment, from which they originate. This is 
usually indicated by the nerve sheath being full and 
thickened, so that you feel it roll under the finger, and it 
will therefore be quite easily palpated. 

II. Tender Nerves. — Tender nerves in the dorsal 
region near the spinal column, indicate a mechanical 
interference involving the integrity of the cellular tissues 
of the nerve, and this is caused by an impingement of 
sufficient magnitude to not only interfere with the vascu- 
lar tissues that pass through the foramen, but also to 
impinge upon and injure the fibers of the nerves. 

We have verified the truthfulness of the nerves being 
slightly impinged, in hundreds of cases. This we know 
to be so, because when a thrust is given to relieve the 
contracted musculature of the spine, approximating the 
vertebrae, where the tender nerve makes its exit, we will 
quickly relieve the tenderness of the nerve. It is an 
impingement of nerves sufficient to interfere with their 
cellular structures in practically all cases, which pro- 
duces tenderness of the nerves. We seldom find a case 
in which the relief of the tenderness of the nerve is not 
immediate, or following soon after overcoming the con- 
traction that approximates the vertebrae. For this 
reason, tender nerves are not only an indication, but a 
positive sign of spinal lesions or vertebral approximation. 

III. Malalignment. — In reference to malalignment 
as a sign of spinal lesions, we refer to the alignment of 
the tips of the spinous processes of the vertebrae. Mal- 
alignment is an indication of spinal lesions in any portion 
of the spine, and is a positive sign of lesions in the cervical 
and lumbar regions, and also in the upper and lower 
thoracic region. 

Malalignment of the spinous processes are easily pro- 
duced by a contraction of the musculature of the spine 



Spondylo-symptomatology. ' 323 

upon one side. If two approximate vertebrae are affected 
by contraction of the muscles upon one side, it at once 
pulls the bodies, and consequently the spinous processes, 
out of perfect alignment. See pages 130, 131. 

Many will judge that the vertebrae is out of place 
because they find that the spinous processes are out of 
perfect alignment, but a little deeper study of the subject 
will disclose to the average mind that there is a contrac- 
tion that is responsible for the nonalignment of the 
spinous processes and also there is an alteration of the 
approximation between the vertebrae produced. 

A contraction of the musculature of the spine on one 
side is more common than is the contraction of the 
musculature upon both sides. This is owing to the 
fact that ordinarily the peripheral irritation of afferent 
nerves, that renexly causes the contractions, is usually 
upon one side and not upon both. There is a tendency, 
however, in case of severe irritation, for the afferent 
impulse to pass from one side of the spinal column to the 
other, and secondarily there is a contraction of the 
musculature of the spinal column upon the other side 
also, but in such cases the secondary contraction on the 
distal side is not as great as it is on the side of the irrita- 
tion and primary contraction. 

IV. Pain — Any Variety. — Pain is the cry of an 
injured nerve. There must be mechanical interference 
with a nerve before any pain can exist. 

Nerves may be interfered with by impingement of 
bone when there is bone upon both sides of the nerve, 
but a nerve cannot be compressed by any other tissues 
of the body. 

We are sure from an extended experience in the relief 
of pain, that the great majority of all pain is produced 
by impingement of a nerve at its point of exit from the 
neural canal. (See Part Two, Chapter X.) 



324 Spondylo-symptomatology. 

V. Deranged Function. — This phenomena is posi- 
tive evidence of interference with the nerve supply. 
While the nerve may not be interfered with directly, it 
may be interfered with indirectly by an impingement 
and depletion of the nutrient supply, or by an occlusion 
of the vessels which drain the segments of its origin — 
the spinal cord. Interference with the nutrient supply 
and with the drainage of the cord that affects the func- 
tional activity of the nerves, is always where these 
vessels pass through the intervertebral foramina. 

Deranged function, then, is indicative of either inter- 
ference with the nerve directly or indirectly by mechanical 
action, and of interference with their nutrition where 
they make their exit from the neural canal ; consequently 
deranged function is a sign of spinal lesions or approxi- 
mations. 

VI. Specific Symptoms. — Catarrh, retention, lack of 
secretion, lack of motion, lack of sensation, loss of voice, 
deafness, and anosmia, are positive signs of an inter- 
ference with the integrity of the nerve supply that is 
responsible for these functions, and therefore becomes an 
indication of spinal lesions by reason of the fact that 
nerves are interfered with where they make their exit 
from the neural canal. 

VII. Anatomical Lesions. — Anatomical lesions that 
are not of traumatic origin, are those of lack of develop- 
ment or cellular alterations as the result of interference 
with the metabolic processes, either in trophic action or 
retention. As the metabolic processes are carried on 
wholly through nerve impulse, these functions at once 
indicate interference with the nerve supply, and conse- 
quently indicate spinal lesions causing nerve interference. 



CHAPTER III. 
SPINAL EXAMINATIONS. 

IN making a successful, thorough and complete exami- 
nation of the spinal column, it is necessary to be 

familiar with the nature and signs of subluxations, 
as given in the previous chapter, and with the methods 
of palpation and of spinal examination. 

Following we enumerate and briefly describe the 
methods of examination that are the most practical, and 
probably most frequently used by those who practice 
intelligently the science of spinal adjustment. 

Position for Examination. — In the examination of 
patients for the discovery of the indications and the 
positive signs of spinal lesions, there are certain positions 
that we prefer our patients to assume and which we 
consider most favorable for the purpose of examination. 

There are certain spinal lesions that are more obvious 
to the examiner in one attitude than in another. 

There are lesions that are manifest, or may be deter- 
mined, when a patient is in one position, that are more 
obscure, and cannot be discovered while the patient is 
in other attitudes. 

For the above reasons we find it helpful in spinal 
inspection and palpation to have patients assume different 
favorable attitudes when a thorough examination is to 
be made. 

The following positions or attitudes we believe from 
our experience, are most favorable for spinal inspection 
and palpation: 

I. The Adams position. 
II. The erect position. 

III. The prone position. 

IV. The dorsal position. 

325 



326 Spondylo-syrnptomatology. 

The Adams Position. — When the patient is directed 
to assume the Adams posture, he may do so by standing 
with his heels approximated and the body bending for- 
ward until the head and trunk are in a straight line, and 
in a horizontal position, and with the hands and arms 
hanging vertically, while the knees are held unflexed. 
This is, we believe, the best position in which to detect 
any twisting or rotation of the vertebrae of the spinal 
column. 

The following observations and notations may be 
most easily made while the patient remains in the Adams 
attitude: 

1. Note if flexion is unrestricted. 

2. Note if flexion is straight forward. 

3. Note the alignment of the spinous processes. 

4. Note any undue prominence of the angles of the 

ribs. 

5. Note if flexion is normal in different parts of the 

spine. 

Restriction of the action or lack of flexibility of the 
spine when the patient is bending forward assuming the 
Adams posture, indicates a settled state of the spine or 
a contractured condition of the musculature of the spinal 
column. 

If the spine does not bend straight forward, but 
rotates or curves to either side, then there exists a con- 
tractured, thickened and shortened condition of the 
muscles, tendons, and ligaments of the spinal column 
upon one side. 

When one or more spinous processes are out of 
perfect alignment, spinal lesions are indicated. Non- 
alignment of spinous processes constitutes positive signs 
of subluxation of vertebrae in all portions of the spinal 
column, except in the middle thoracic region, from about 
the fourth to the ninth thoracic vertebrae, or spinous 
processes thereof. 



Spinal Examinations. 327 

Any undue unilateral prominence or elevation of the 
angles of the ribs on either side, when they are uncovered 
by the scapulae as the patient is flexed in the Adams 
position, denotes rotation of the vertebrae upon their axes. 

Any abnormal stiffness in any segment of the spinal 
column, indicates a contractured condition of the tissues 
of that region. Such contractured condition of the 
ligaments of the spine will engender interference with 
the spinal nerves and health of the viscera, and other 
anatomical structures, which receive their nerve supply 
from the unnexible or contractured segment. 

II. The Erect Position. — In assuming the erect 
attitude, the patient may sit upon a stool, but the 
preferable plan is for the patient to stand erect with his 
heels together, and with his hands hanging at his side, 
while the following observations and notations are being 
made: 

1. Note the spinous processes. 

2. Note the angles of the ribs. 

3. Note the curvatures of the spine. 

4. Note the prominence of the scapulae. 

5. Note the comparative height of the scapulae. 

6. Note the comparative height of the iliac crests. 

7. Note the transverse processes of the lumbar ver- 

tebrae. 

The above observations made while the patient 
remains in the erect posture, either sitting or standing. 
are for the special purpose of detecting spinal curvatures 
and rotation of dorsal and lumbar vertebrae upon their 
axes. 

The difference in height of the scapulae and of the 
iliac crests of the innominate bones, is indicative of 
scoliosis, while lateral positions of the spinous processes 
and anterior or posterior positions of the transverse pro- 
cesses, and an elevation of the angles of the ribs, indicate 
rotation of vertebrae upon their axes. 



328 Spondylo-symptomatology. 

III. The Prone Position. — When the patient is to 
be examined in the prone position, he is usually placed 
upon a smooth surface or a flat couch or table that is 
especially prepared for this purpose, as to length, width, 
and height. 

The proper length of tables for this purpose is about 
five and a half feet. The width of the table should be 
from fourteen to sixteen inches, and the height of it 
should be about sixteen or eighteen inches. The latter 
dimension, however, should be regulated according to 
the height of the one who is to palpate the spinal lesions 
and make the adjustment. 

Tables that are made for the purpose of giving spinal 
adjustment, should be so built that they may be adjusted 
properly for convenience in spinal inspection and palpa- 
tion, while the patient remains in the prone position upon 
the level surface of the table. 

The curvatures of the thoracic and lumbar portions 
of the spinal column that are apparent when the patient 
is in the erect or standing attitude, are altered and 
decidedly changed when the patient assumes the prone 
position upon a flat couch or surface, and the alteration 
will correspond in amount to the degree of prominence 
of the patient's abdomen, and the condition and flexi- 
bility of his spine. 

Certain pathological conditions materially affect the 
flexibility of the spine, and consequently the changes, 
which are produced in the curvatures of the spine, by 
changing the patient from the erect to the prone position, 
are altered. 

1. Deficient tonicity and weakness of the muscles of 
the spine may result from rickets and other constitutional 
diseases or weakness existing during a convalescence. 
Such conditions influence the curvatures of the spine, 
and there is an inclination toward an increased convexity 
of the spinal column backward when the patient is in 



Spinal Examinations. 329 

the prone position, but this convexity may diminish or 
disappear when the patient assumes the lateral recumbent 
position. 

2. Spondylitis deformans may produce a general and 
permanent convexity of the spinal column backward. 
The movements of the spine are diminished or lost, and 
the changes in the curvatures of the spine are not influ- 
enced by movements or by changes in the position of the 
patient from one attitude to another. 

3. We may observe a long continuous curve of the 
spinal column to either side, which curvature, although 
permanent, may be altered by changes in the position 
of the patient, and there may exist a very little or no 
rotation of the vertebrae on their spinal axes associated 
therewith. 

4. Scoliosis, which is a lateral curvature of the spine, 
is often co-existent with a straight condition of the antero- 
posterior surfaces and sometimes with a lordosis — a for- 
ward curvature — of the spine between the scapulae, and 
these conditions are usually associated with a rotation 
of the spine, and they always materially change or de- 
stroy the natural curvatures of the spine in the thoracic 
region, and alter the anterior concave curvature of the 
lumbar vertebrae. 

5. In weakened conditions of the spine, as in a hysteri- 
cal patient, we may have a lateral curvature of the spinal 
column without any rotation of the vertebrae, but the 
lateral deviation or scoliosis, will disappear when the 
patient assumes the recumbent position. 

6. In Potts disease we have caries of the centrums or 
bodies of the vertebrae, which will often permit a sharp 
curvature of the spine in the thoracic or lumbar region, 
as a result of the superimposed weight of the body. Such 
conditions are evidenced by a local, abrupt, and permanent 
kyphosis. 

7. The senile spine is a perceptibly shortened and 



330 Spondylo-symptomatology. 

stiffened spine, and is the natural result of the settling 
that occurs as age advances, when the patient is not 
treated by spondylo therapy methods, sufficient to keep 
the spine in a normal condition. When the spine is 
neglected, it will gradually become shortened. The inter- 
vertebral cartilages become impacted and thinned. Ten- 
dons and ligaments of the spine will become thickened, 
shortened, and contracted, and in this way the spine 
loses its length and flexibility, in proportion as the above 
conditions are increased, as the result of the settling of 
age. The spinal column of the aged truly bears the 
marks of the footprints of time, unless a good Samaritan 
treats the spine and keeps it adjusted and normal. 

We can most easily examine and most accurately 
palpate and determine spinal lesions while the patient 
remains in the prone attitude. The spinous processes are 
most easily palpated and the transverse processes are 
best examined while the subject is in the prone position. 

In this same attitude we are enabled to determine the 
existence of the contractured lesions of the spinal mus- 
culature. Also nerves may be palpated if tender or if 
the nerve sheath is congested and indurated, we are best 
enabled to discover their condition with the patient prone 
upon the treatment table. 

Nerve tracing can more easily be done in many cases 
by examination and palpation of the spinal nerves while 
the patient remains in the prone attitude upon the 
examination and adjustment table. 

The prone position or attitude of the patient upon 
the examination table is used by many who practice 
spinal adjustment almost to the exclusion of all other 
attitudes, and this is the attitude in which many have 
them remain while giving the entire treatment. This is 
the best position for giving thrusts upon the spinous 
processes and for adjustment of the cervical and upper 



Spinal Examinations. 331 

thoracic vertebrae when using some of the improved 
methods of adjustment. 

IV. The Dorsal Position. — This position is by far 
the best, and is practically the only position for the 
patient to assume that will enable us to accurately 
palpate the spinous processes of the cervical vertebrae. 

As the patient lies in the dorsal recumbent position 
upon the couch or table, the palpator, while standing 
at the patient's head, may raise it between his two hands, 
while with the tips of the index and middle fingers he 
may palpate, and can easily determine the alignment or 
nonalignment of the spinous processes of the upper two 
or three dorsal, and of all of the cervical vertebrae. 

If the head is flexed sufficiently, the forward curvature 
of the cervical region will be changed to a backward 
convexity, and the spinous processes of the cervical 
vertebrae will be separated so that their alignment may 
be easily distinguished by palpation. 

In this position we palpate to investigate the align- 
ment of the spinous processes of the cervical vertebrae, 
and also to examine the comparative size of the inter- 
spaces between the spinous processes of each consecutive 
pair of vertebrae. 

The advantage of this position in the palpation of the 
cervical spinous processes, is, that the extensor muscles of 
the neck are at absolute rest, while the head is being 
raised, and consequently non-resistant to the palpating 
fingers. It is only the flexor muscles of the cervical region 
that may be put in action by the patient, provided he 
tries to assist the palpator by helping to raise or hold his 
own head in an elevated position. 

If we try to palpate the cervical vertebral processes 
while the patient is sitting or standing erect, we find them 
more or less obscured because of the action and slight 
contraction of the extensor muscles in holding the head 
erect. We use almost exclusively the dorsal decubitus 



332 Spondylo-symptomatology. 

position in the palpation of spinal lesions of the cervical 
vertebrae, especially those lesions which are indicated by 
the malalignment of the spinous processes. 

In spinal palpation we look for all evidence of spinal 
lesions, both from the standpoint of the condition of the 
spine, and from the standpoint of the functional phenom- 
ena, which are indicative of the spinal condition. 

We enumerate below some of the principal symptoms 
or lesions of spinal articulations that we consider in 
spinal palpation: 

I. Contractures. 
II. Nerve tenderness. 

III. Thermic alterations. 

j Curvature. 

IV. General condition \ Flexibility. 

( Muscularity. 
V. Superficial tenderness. 
VI. Position of spinous processes. 
VII. Position of transverse processes. 

I. Contractures. — The subject of contracture has 
been considered quite fully in a previous chapter, and 
for that reason we will pass it in this connection. 

II. Nerve Tracing. — See the next chapter. 

III. Thermic Alterations. — This question has been 
discussed in the previous chapter. 

IV. General Outline. — This feature has been con- 
sidered above, in this chapter. 

V. Superficial Tenderness. — Often in certain seg- 
ments of the spine we find the peripheral tissues tender, 
which indicates a tenderness of the posterior primary 
branch of the spinal nerve from that segment. 

This tenderness means that the nerve underneath 
the tender segemnt of the spine, is itself tender. By 
palpating along the spine, we may readily elicit tender- 



Spinal Examinations. 333 

ness, which will be manifest by the expression or state- 
ments of the patient. Now, if you have done no adjust- 
ment to produce a tenderness, then the tenderness must 
be a result of impingement of the nerve trunk from which 
the posterior primary division to the tender zone is given 
off. This is a positive sign of an interference with the 
nerve that gives off the branch to the tender zone. 

VI. Position of Spinous Processes. — We enumerate 
some of the positions in which we determine the spinous 
processes to be, by palpation: 



1. Superior. 

2. Inferior. 

3. Anterior. 

4. Posterior. 

5. Approximated. 

6. Left lateral. 

7. Right lateral. 

These different positions of the spinous processes 
mean a deviation of the position of the centrums of the 
vertebrae from the normal. These positions may be easily 
made out by the trained hand of the palpator. The 
significance varies in different portions of the spinal 
column. 

VII. Transverse Processes. — The transverse pro- 
cesses are not so easily palpated, as their position is not 
so accessible to the touch, and more especially is this 
true in case of excessive muscularity of the spine, or in 
case of an accumulation of adipose tissue. 

In some spines, however, the transverse processes are 
easily palpated, and we may easily determine any mal- 
positions, and we will enumerate the following abnormal 
positions, or abnormal indications that we obtain from 
palpation of transverse processes: 



334 Spondylo-symptomatology. 

1. Torsion. 

2. Approximation. 

3. Both superior. 

4. Both inferior. 

5. Both anterior. 

6. Both posterior. 

7. Compound malpositions. 

For a further discussion of these positions, see Chapter 
IV., Part Four. 



CHAPTER IV. 
SPINAL LESIONS. 

THE nature of the lesions that occur in the spinal 
column have received no consideration from the 
regular medical profession, and are very poorly 
understood by a majority of practitioners of spinal 
treatment. The use of the term subluxation gives a 
wrong impression as to the nature of the spinal lesions 
such as we have to deal with in spinal adjustment. The 
laity generally and many practitioners of the healing 
art do not differentiate the difference in meaning between 
the terms luxation and subluxation. To so many the 
term subluxation gives the idea of a vertebra being out 
of place or luxated. This misconception of the meaning 
of the term subluxation calls for many explanations by 
anyone using this term. 

The erroneous views held concerning this subject are 
due also to a wrong conception and wrong teaching on 
the part of some who pose as leading teachers of chiro- 
practic spondylotherapy. We have heard some teachers 
claim that vertebras, from some accident, fall or move- 
ment, as the act of turning in the bed, would slip out of 
place, and also that vertebras would slip out a little at 
a time, when turning over in bed, until they would get 
entirely out of place. 

We have heard teachers claim that an adjustment 
was simply pushing vertebrae back into their place, and 
if the vertebra when adjusted would not remain in its 
proper place they would push it back into place again 
every day until it would remain where it belonged. Such 
ideas are only entertained by those who know little or 
nothing of the human anatomy. 

A true conception of spinal lesions and of spinal sub- 

335 



336 Spondylo-symptomatology. 

luxations is very different to what is usually supposed 
by the laity and poorly or wrongly educated doctors. 
Anyone with a competent knowledge of the structural 
formation of the spinal column and its musculature, and 
with ordinary mental capacity, would know that vertebrae 
will not be slipping out of place as the result of an accident 
or movement, nor slipping into place as the result of a 
thrust upon the spine. 

That spinal lesions do exist is a fact, but that they 
occur in the manner or for reasons, and are of the nature 
as indicated above, is far from being the true facts in 
the case. 

We may ask the question, why so many uneducated 
people conclude that vertebrae do slip out of place from 
trivial causes, and that they slip them back again by an 
adjustment. To my mind, this is due to the fact of the 
nonalignment of the spinous processes, as referred to in 
the previous chapter, which occur as the result of uni- 
lateral muscular contraction. 

When a contraction interferes with the approximation 
and alignment of the centrums of adjacent vertebrae, 
this will of necessity draw the spinous processes out of 
proper alignment, and this feature of malalignment of 
the spinous processes is much more marked in the central 
portions of the thoracic region than in other regions of 
the spine. This is because of the length of the spinous 
processes in this region. 

As a result of the nonalignment of the spinous pro- 
cesses, and also as the result of the lack of proper align- 
ment of the transverse processes, which may be detected 
in many cases, we may determine certain peculiar sub- 
luxations of vertebrae. 

We will enumerate, then, in this connection, some of 
the apparent subluxations that may be determined as 
the result of forcing vertebrae from their normal position 
as indicated by the processes of the vertebrae. Spinal 



Spinal Lesions. 337 

lesions may actually occur as a result of traumatic 
violence to the spinal column: 
I. Torsion (twisting). 
II. Anterior subluxation. 

III. Posterior subluxation. 

IV. Left lateral subluxation. 
V. Right lateral subluxation. 

j Anterior. 



? Left 
VI. Compound 

'Right 



I Posterior, 
j Anterior. 
I Posterior. 



VII. Approximated on s._ ,, ' 

I Both sides. 

Of the different subluxations referred to above, some 

of them may exist in fact, while most of them exist 

apparently as a result of unilateral, muscular contraction. 

I. Torsion. — Torsion means a twisting of a vertebra 
upon its axis, and such a condition is indicated by: 

1. Lateral position of the spinous process. 

2. Anterior position of one transverse process. 

3. Posterior position of one transverse process. 

4. Anterior position of one of the transverse processes 
and a posterior position of the other transverse process. 

In the cervical region, by a palpation of the spinous 
processes, we often find one of them to the right or to the 
left, relative to the adjacent spinous processes above and 
below. 

Now, this lateral condition of a spinous process in 
the cervical region would indicate a slight torsion or 
twisting of the vertebra upon its axis. The same indica- 
tion may be found in the spinous processes of the lumbar 
vertebrae, and in this portion of the spine we may also 
have a twisting or slight torsion of the vertebrae. 

II. Anterior Subluxation. — The anterior subluxa- 
tion is a rarity, and rarely occurs in some regions of the 



338 Spondylo-symptomatology. 

spine, but evidently does exist in certain spines in certain 
regions. 

The fifth lumbar vertebra is wedge-shaped, and the 
thickened portion of its centrum is anterior. This favors 
a forward movement of this vertebra. This vertebra 
also supports the superimposed weight of the entire 
trunk. Any weights or jars upon the shoulders or the 
upper part of the body, will spend their force at the lower 
end of the spinal column, where a movable vertebra 
joins a solid vertebra, as where the fifth lumbar articu- 
lates with the sacrum. 

If a person lights on his feet solidly, this will throw a 
tremendous force upon the fifth lumbar and the sacrum 
because of a union there between a solid segment and a 
movable segment of the vertebral column. The ligaments 
of this portion of the spine are strong as a protection 
against lesions, but the other conditions of this articula- 
tion are unfavorable as a protection. 

In the cervical regions we are sometimes able to 
detect by deep palpation, in which we press the fingers, 
in front of the sterno-cleido-mastoid muscle, into the 
deep soft tissues of the neck, an unevenness of the 
centrums of the vertebrae. 

An anterior protuberance is sometimes sufficiently 
prominent to be easily determined by palpation. For 
the above reason, we are forced to a conclusion that there 
must be such a thing as anterior, or a lateral anterior 
position of the centrums of the vertebrae in the cervical 
region. In very rare instances we have an indication of 
a forward subluxation of the bodies of vertebrae in the 
thoracic region, which is indicated by a deep or anterior 
condition of one or both of the transverse processes. 

III. Posterior Subluxations. — Such lesions do not 
often occur in the cervical nor in the lumbar regions. 
Posterior subluxations are more liable to occur in the 
thoracic region and this is due to the natural posterior 



Spinal Lesions. 339 

curvature extending throughout this entire region. 
Throwing the head violently backward is apt to throw the 
superior thoracic vertebrae backward. In clinical exper- 
ience we discovered a backward or posterior subluxation 
of the upper thoracic vertebrae, which, according to the 
history given, was caused by the kick of a shot-gun. 
Lifting in a cramped position may cause a backward 
subluxation in the thoracic regions. 

IV. and V. Left Lateral and Right Lateral 
Subluxations. — Apparent subluxations of this nature 
may be the result of a unilateral contracture of the spinal 
musculature, affecting two adjacent vertebrae. There is 
no doubt that the condition produced in this way explains 
the cause of all apparent subluxations, to the right or to 
the left, of vertebrae. It would hardly be possible for a 
vertebra to move directly to the right or to the left 
except as the result of extreme violence. Apparent 
lateral subluxations are more inclined to be of a compound 
nature as left anterior or left posterior. 

VI. Compound Subluxations — The compound sub- 
luxations are the more common; in fact, the most 
probable sub'uxations of vertebrae, and they may be 
either to the right or to the left, and the lateral subluxa- 
tions are more apt to be associated with an anterior or 
posterior condition of the centrums of the vertebrae. 

No doubt the compound subluxations are the more 
numerous, if not the only kind of subluxations we have 
of a lateral nature. 

VII. Approximation. — An approximated condition of 
the spinous process or of the transverse processes of the 
vertebrae is positive evidence of an approximation of the 
centrums of the vertebrae. 

In the unilateral contractions, we have an approxima- 
tion upon the same side between the adjacent vertebrae 
affected by the contraction. If, however, we have a 
secondary contraction on the opposite side, we may have 



340 Spondylo-symptomatology. 

a uniform approximation of the articular surfaces of the 
adjacent vertebrae. Unilateral approximation would be 
indicated by a lateral condition of the spinous process of 
the vertebrae involved, and would also be indicated by 
the interspace between the transverse processes of the 
vertebrae. 

A uniform approximation of the vertebral articulation 
does not affect the alignment of either of the spinous or 
transverse processes, but it does narrow the interspace 
between them. 

The above conditions or subluxations are practically 
malpositions in which a vertebra may be forced by 
traumatisms or by muscular contraction from its normal 
approximation, and while such conditions are not 
apparent, there is no doubt of there being a reality of 
the existence of such lesions in a great many cases. 

There is one important point in this connection that 
might be well to remember. A thrust that tends to throw 
a spinous process into proper alignment, will of necessity 
relax the contracted musculature that draws it out of 
its proper alignment. This fact is in favor of the one 
making an adjustment or giving a thrust, as ordinarily 
the careful palpator would apply his thrust so as to 
throw the processes into proper alignment, and thus 
affect the tissues that cause nonalignment. 

A careless thrust, without regard to the above fact, 
may fail to accomplish any favorable results, as the con- 
tract ured tissues would be less yielding than those that 
were normal; thence a thrust not properly applied 
would only act upon the musculature that was normal 
and most elastic, while the contracted and non-elastic 
tissues would be practically unaffected. This fact 
emphasizes the importance of careful and painstaking 
palpation to determine the nature of all spinal lesions. 

Signs of Subluxation. — Indications and signs of 
subluxation are only evident to a person who has made a 



Spinal Lesions. 341 

study of this subject, and who has had actual experience 
and training in the detection and classification of the 
different symptoms and signs that exist. 

The different signs of subluxations of vertebrae are 
not always easy to determine or to discover, for several 
reasons, one of the principal reasons being, that the 
muscular tissues may be so heavy over the bony promi- 
nences of the spinal vertebrae, and sometimes the other 
symptoms are obscured because of the abundance of the 
musculature of the spine which covers up the indications. 
We enumerate below the signs of subluxations: 
I. Pain. 
II. Tender nerves. 

III. Thermic alteration. 

IV. Derangement of function. 

V. Malalignment of spinous processes. 
VI. Malposition of transverse processes. 

VII. Contractures of the spinal musculature. 

In the above enumeration of spinal symptoms, we 
give nearly the same list as we do under the indications 
of disease. This is because spinal lesions cause deranged 
function, which is disease, therefore the signs of spinal 
subluxation become at once the signs of disease. This 
subject, however, has been practically covered in Chapter 
II.; therefore we say but little upon the special signs 
of subluxations in this connection. 

I. Pain. — Pain, as stated in Chapter II., is a positive 
sign of a subluxation, and indicates mechanical inter- 
ference and irritation of nerves, which can occur only 
in the human body from internal nerve pressure where 
the nerves make their exit from the neural canal. 

II. Tender Nerves. — By careful palpation along 
either side of the spinous processes, an inch or two 
from the median line, we may find nerves that are tender 
to the touch and we may know that the tenderness is 
due to a mechanical irritation of the nerves, and is usually 



342 Spondylo- symptomatology. 

caused by a mild impingement. The more decided 
mechanical interference, though, will produce pain in 
addition to the tenderness of the nerve. 

III. Thermic Alteration. — In the enumeration of 
the functions of the nerves, we notice that the thermic 
control is one of its functions. Any spinal interference 
with the nerve that will alter or change the functional 
activity thereof, will alter the thermic conditions in the 
zone supplied. Any excitation because of slight anaemia, 
or because of slight impingement, will produce an exag- 
gerated functional activity, and consequently an increased 
thermic action. 

In palpation of the spine we often find segments that 
are warmer than adjacent segments. This at once 
indicates spinal interference with the nerve supply, or 
spinal subluxation. If the spinal interference is excessive 
and of sufficient length of time, we will have a failure of 
the normal functioning of the nerve. This at once causes 
depreciation of the thermo-genetic action, and conse- 
quently we will have a cold segment of the spine, as 
compared with the adjacent segments, below and above. 

For the above reasons, a hot and cold segment of the 
spinal column indicates spinal lesions and interference 
with the spinal nerve supply to the segment of altered 
temperature. 

IV. Derangement of Function. — As nerves are 
interfered with where they make their exit from the neural 
canal, and as they are not interfered with at any other 
point, or cannot be, except from trauma, we are sure that 
functional derangement then, is due to spinal interference 
with the nerve supply, and for this reason functional 
derangement is a direct index as to the condition of the 
nerve supply, and any derangement of this phenomena 
is positive evidence of spinal lesions interfering with the 
spinal nerve supply. 

Under the head of deranged function we might 



Spinal Lesions. 343 

enumerate some of the different functions of nerves, so 
as to bring before our minds some ways in which the 
functional derangement may be manifested: 

, Tvyr .• I Direct. 

1. Motion. ->_ _ 

o xt + .4-' I Reflex. 

2. Nutrition. 

3. Inhibition. 

4. Temperature. 

5. Mental phenomena. 



6. Glandular activity. 

I Excretion. 



j Secretion. 

) 
7. Afferent transmission. 

Under the influence of the normal nerve supply there 
can be no derangement of function, except in cases of 
trauma or retention, hence the correctness of our 
statement, that deranged functional phenomena is a 
symptom of spinal lesions and their results. 

V. Malalignment of Spinous Processes. — The 
position of the spinous process is almost a positive sign 
of a subluxation; however, near the center of the thoracic 
region we may have spinous processes that are crooked, 
and owing to this frequent occurrence of crooked spinous 
processes in the middle thoracic region, the lack of align- 
ment does not constitute a positive sign, but is only 
an indication of a subluxation. 

In the cervical and upper thoracic and in the lower 
thoracic and lumbar regions, the alignment of the spinous 
processes becomes a positive sign in practically all cases 
of the position of the vertebrae. 

VI. Malposition of Transverse Processes. — The 
transverse processes are more positive signs of the real 
position of the vertebrae in all regions, than is the align- 
ment of the spinous processes. 

We sometimes have difficulty in palpating transverse 
processes in backs that have a superabundance of muscu- 
lar or adipose tissues. 



344 Spondylo-symptomatology. 

If the two transverse processes of the vertebra are 
more posterior than adjacent spinous processes above and 
below, then this would indicate a posterior condition of 
that special vertebra. 

If both of the transverse processes of a vertebra are 
more anterior than adjacent transverse processes above 
and below, this would indicate an anterior condition of 
the vertebra to which they are attached. 

Contraction between the two transverse processes of 
any vertebra and those of the adjacent vertebra below 
or above, would indicate an approximation, while any 
rotation upon the axis of the vertebra, would be indicated 
by either an anterior condition of one spinous process, 
and a posterior condition of the opposite spinous process, 
or a slight rotation will be indicated if only one of the 
processes was either anterior or posterior. 

VII. Contractures of the Spinal Musculature. — 
As outlined in the chapter above, they are positive signs of 
subluxation of vertebrae, and the nature of the subluxation 
would depend on whether or not the muscular contraction 
is unilateral or bilateral. 

In the chapter above we referred to derangement of 
function. As a convincing evidence of the fact that 
contraction of the musculature of the spine is the result 
of nerve interference, we notice that when we adjust to 
relieve interference with the nerve supply, that almost 
instantly, as if by magic, the contraction of the muscular 
tissues subsides and the hard muscular band disappears. 

In our experience we have often seen muscular bands 
extending from the spine on either side from one or 
several parts of the spine, and noticed that immediately 
after adjustment to open up the spinal articulation to 
relieve interference with the nerve supply, that the 
muscular bands would disappear immediately and the 
muscles resume their normal condition. 



CHAPTER V. 
PALPATION. 

PALPATION is one of the principal methods of a 
clinical examination of patients, which has been 
long used by all practitioners of the healing art. 
Palpation may be denned as follows : The act of touching 
or feeling; or in clinical practice it may be defined as a 
method of physical examination by the gentle applica- 
tion of the hand or fingers to the surface of the body for 
the purpose of determining the condition of the surface 
and adjacent parts of a certain locality or organ of the 
body. 

Palpation, in a general way, is used to determine a 
number of different conditions, which may be enumerated 
below under the following headings: 
I. Pulse rate. 
II. Temperature. 

III. Spinal lesions. 

IV. Visceral outline. 
V. Condition of skin. 

VI. Local abnormal size. 
VII. Local abnormal shape. 

The elicitation of the condition, relative to the matters 
enumerated above, are all of prime importance, but in 
this connection our consideration will be principally 
concerning the art and science of palpation for the deter- 
mination of spinal lesions. 

Formerly palpation has been used for almost any 
other purpose but that of obtaining data for spinal treat- 
ment. The most important phase of the subject of 
palpation, is that of palpation of the spine for the 
determination of the evidences of interference with 
nerve supply. 

345 



346 Spondylo-sympto7natology. 

This method is used almost to the exclusion of all 
other methods of examination by some, especially those 
whose treatment is exclusively that of spinal adjustment. 
Some of the things that we may determine by palpa- 
tion of the spinal column, may be enumerated as follows: 
I. Pain. 
II. Tender nerves. 

III. Thermic alterations. 

IV. Congested neural cords. 
V. Contractured musculature. 

VI. Malposition of spinous processes. 

VII. Malposition of transverse processes. 

The methods of spinal palpation vary considerably 
among the different practitioners of this art; in fact, it 
seems a fad among a new school to try to initiate some 
peculiar and distinctive method of palpation in order to 
have something entirely different from all former methods. 
There is a disposition to call black, white, or white, 
black, in order to make it appear that all former methods 
have been wrong, and to make the methods of a new 
science entirely and distinctively different from all 
former usages and methods. 

For this reason there have been certain methods of 
palpation adopted, used, and taught that are not very 
practical; in fact, cumbersome and unsatisfactory. 

Palpation consists of locating the lesions or conditions 
or the indications of the lesions enumerated above, and 
the fingers may be used in any manner according to the 
custom and practice of the palpator. Some use three 
fingers almost exclusively in the palpation of the spinous 
processes of the vertebrae of all the different regions of 
the spinal column. Others prefer to use two fingers of 
the same hand, and can detect more accurately the 
nature of the lesion in this way than they can by the use 
of three. 

In examination of certain regions of the spine, we 



Palpation. 347 

find that one finger of each hand is preferable in deter- 
mining any deviations from the normal, as sensation is 
less acute when two or more fingers are used. 

Position. — For palpation of the spinal column, it is 
preferable that the patient lie prone upon an adjustment 
table, and the table should be perfectly level, unless 
there should be considerable prominence of the abdomen, 
in which case some provision should be made to make 
room for the enlargement thereof and to prevent the 
kyphotic curvature interfering with or destroying the 
normal contour of the spinal column in case room is not 
provided. 

In this position the muscles may be completely 
relaxed, with the shoulders hanging over the edge of the 
table, so that we are enabled to palpate the thoracic and 
lumbar regions of the spinal column with considerable 
ease and accuracy. 

Most of the abnormal conditions of the spine may be 
detected in this position, by palpating, preferably, with 
two fingers. By the use of two fingers the sense of touch 
is more acute than when three or more fingers are used. 

It is also well to pass the fingers along the spinal 
column while the patient is standing, or sitting in an 
upright position. By taking this precautionary method 
of examination, we may sometimes be able to detect 
certain lesions of the spinal contour that do not appear 
so plainly when the patient lies prone upon the table. 

The use of the upright position, and also the prone 
position of the patient in making examinations, therefore, 
is a more perfect way of determining all lesions that may 
occur, than by the use of only one position of the patient 
in examination. See Chapter III., Part Four. 

Palpating with three fingers has been used in the 
thoracic region; in fact, in all regions of the spine. An 
effort is made to pass the tips of the three fingers against 
three consecutive spinous processes, and in this way to 



348 Spondylo-symptomatology . 

determine if they are in perfect alignment. This method 
of determining the position of the spinous processes is 
very indefinite, however. If the fingers are placed 
properly against the sides of the processes, it is then a 
hard matter to judge if they are, or if they are not, in 
perfect alignment. 

A much better method may be used, and for this 
reason we do not use the three-finger method in any 
region of the spine, except in the palpation of the atlas. 
Using two fingers of the same hand is a very practical 
and a fairly accurate method of determining several 
points concerning the condition of the spinous processes. 

By palpating with two fingers astride of the spinous 
processes, we can readily detect the size of the interspace 
between the spinous processes, and any posterior or 
anterior condition of a spinous process, and also detect 
any lateral deviation from the normal alignment. 

With two fingers the sense of touch is much more 
acute than with three. For this reason, we almost exclu- 
sively use only two fingers in palpation in our practice; 
we use the tips of two fingers in palpating the spinous 
processes in all regions of the spinal column. 

In palpation of the transverse processes, we find it 
better to use one finger of each hand, one on either side 
of the spinous processes. We can detect any elevated or 
posterior condition, or a depressed and anterior condition 
of the spinous process with ease, provided the musculature 
of the spine is not too abundant or too much indurated. 

I. Pain. — In palpating for the purpose of eliciting 
pain, we press gently with one finger by preference over 
the spinal exit of the nerves. 

II. Tender Nerves. — For tenderness, we palpate 
the interspinous spaces as well as over the spinal origin 
of the nerves, for the reason that if a spinal nerve is 
tender, the primary posterior division, to the musculature 
of the spine, will also be tender, and this tenderness may 



Palpation. 349 

be elicited on the top of or in the interspaces between 
the spinous processes. 

III. Thermic Alterations. — By gentle pressure, and 
by the sense of touch, we may easily detect any alteration 
of the temperature of any segment or portion of the spine. 
Alterations are determined by noticing the comparative 
temperature of the different spinal segments. 

A nerve that is irritated, excited, or in any way has 
its functions increased, will cause an increase of tempera- 
ture in that zone of the spinal column which it supplies. 
By the temperature of any zone of the spinal column, we 
are enabled to determine what nerves are interfered with, 
as the interference is almost universally at the point 
where the nerve makes its exit from the spine. We then 
can relieve the interference with the nerve, by relieving 
the contracted musculature of the zone of the increased 
temperature. 

We sometimes have conditions of a subnormal tem- 
perature of one or more zones of the spinal column. In 
such cases, we will detect a cold or cooler segment of 
the spinal column, as compared with the other portions 
of the spine. This indicates that the nerves from this 
region of the spine are depressed, and their action is 
below normal. 

The lack of heat production is due wholly to the lack 
of the thermic function of the motor nerves. We find this 
condition of cold segments of the spine associated with 
paralytic conditions and hypo-tonicity. 

IV. Congested Neural Cords. — The nerve sheath, 
in which the nerve and the accompanying vessels make 
their exit from the spinal column, will, as the result of 
impingement, become congested, thickened and enlarged. 
The palpating finger will often detect the nerve sheath 
as a roll, quite distinctly under it, as the finger palpates 
by a rolling movement over the neural sheath. It is 
often difficult to detect the neural sheath, because of the 



350 Spondylo-symptomatology. 

muscles overlying it, but when the muscles are thin, and 
well relaxed, then the neural sheath is easily palpated if 
it is congested and indurated. 

Often, however, the muscles over the neural sheath 
are also contracted, because of the increased motor 
impulse to the muscular tissues. We have often noticed 
that the neural sheath which was so easily palpated, 
would entirely disappear immediately after a thrust for 
the purpose of relaxing contractures that cause the 
impingement and the consequent nerve interference and 
congestion of the neural sheath. 

V. Contractured Musculature. — The contracted 
musculature of the spine is positive evidence of an irritat- 
ing, stimulating, or exciting influence acting upon the 
efferent motor nerve to the muscles of the spine. 

If a nerve is interfered with in such a way as to be 
excited, all branches of that nerve may partake of the 
excitation. 

The posterior primary branch of a spinal nerve sup- 
plies the musculature of the segment of the spine from 
which the nerve originates. Then contractured mus- 
culature of any segment of the spine is positive evidence 
of an interference with the nerve from that segment. 
Often these muscles stand out like hard bands, because 
of the nerve irritation. These bands sometimes run at 
an acute angle, laterally from the spinal attachment of 
the muscles. Incidentally they will mark the location 
of the spinal contractures that interfere with the nerves. 

The masseur undertakes to overcome this abnormal 
condition by kneading and massaging the muscles. No 
doubt the massage, kneading or vibration of the mus- 
culature of the spine has a sedative effect upon the nerve 
supply, and reflexly will cause a relaxation, but the time 
required is considerable in some cases, and the method is 
too slow for practical use. 

There are cases in which spinal massage may be 



Palpation. 



351 




Illustration of method of marking tips of spinous process and of the 
graphic manifestation of the malalignment of them. 



352 Spondylo-symptomatology. 

helpful as a preparatory treatment to our more specific 
and positive methods of relieving interference with the 
nerve supply, and consequently relieving the contractured 
condition that excites the muscular contraction by 
excitation of the spinal nerves. 

It is well to remember that the nerves may be excited 
or stimulated by a mild impingement or by a slight 
anaemic condition of the spinal segment. We frequently 
notice that large contractured bands of muscles will 
relax almost immediately after an adjustment to relieve 
interference with the nerves which supply them. 

When the muscles stand in ridges, a thrust opening 
the proper spinal articulations is a specific and immediate 
remedy for contractured spinal muscles. 

VI. Malposition of the Spinous Processes. — Mal- 
position of the spinous processes may be detected in 
different ways, and the significance of a lateral condition 
of a spinous process varies in the different regions of the 
spine. 

We may detect lateral conditions of a spinous process 
in the thoracic and lumbar regions by palpating with 
two fingers, fairly well, but a more accurate way and a 
more satisfactory method is that of marking the tips of 
the spinous process. 

Use any pencil that will leave a distinct mark upon 
the surface of the skin, and mark the length and direction 
of the center of the tip of the spinous processes. The skin 
may be drawn carefully and tightly over the process 
while it is caught and held between two fingers, being 
careful not to draw the skin to either side. When the 
process is plainly and clearly felt between the fingers, it 
is easy to mark the center of the tip of spinous process, 
and also to mark the length of it. 

If all the spinous processes in the thoracic and lumbar 
regions are marked in this way, we can easily determine 
by inspection any deviation of the spinous processes 



Palpation. 353 

from their normal alignment. This is many times more 
accurate and more instructive as to the nature of spinal 
lesions, than are the blind finger tips of a palpator, 
notwithstanding any amount of training and experience. 

VII. Malposition of Transverse Processes.— 
Malposition of the transverse processes may be palpated 
with considerable accuracy in the thoracic and cervical 
regions, but we pay but little attention to the transverse 
processes in the lumbar region, nor do we pay as much 
attention to the transverse process of the cervical region 
as in the thoracic region. 

In the lumbar and cervical regions we find that the 
spinous processes are quite positive indications of lateral 
conditions, or subluxations. 

In the thoracic region the spinous processes are at 
most but slight indications; especially is this true in the 
middle thoracic region. In the middle thoracic region, 
then, we pay more attention to the position of the trans- 
verse process than we do to the alignment of the spinous 
process. 

Palpation to determine malposition of transverse 
processes is almost exclusively confined to the thoracic 
region. It is best to use the tip of a finger of each hand, 
one on either side of the spinous processes, in palpating 
the transverse processes of the thoracic region. 

The ease with which we may palpate transverse 
processes depends upon the amount and condition of the 
musculature of the spine of the patient. If the muscles 
are soft, we may, by deep palpation, detect very easily 
the relative position of the transverse processes, but in 
case of contractured musculature, or of excessive amount 
of tissue along the spine, we find it very difficult to pal- 
pate transverse processes. In such case as the latter, we 
must depend upon detecting tender nerves, and upon the 
condition of the musculature as to bands and contraction 
remainder. 



354 Spondylo-symptomatology. 

We would call special attention to the palpation of 
the cervical vertebrae. With a great many, an accurate 
palpation of the cervical vertebrae is very difficult. 

We use a number of different methods in order to 
gain information as to the normal alignment of the 
cervical vertebrae, and even then at times we find it 
difficult, owing to the indurated and contractured condi- 
tion of the musculature upon the posterior portion of the 
cervical region. These indurated segments of muscles may 
be local lesions or knots. Sometimes they may embrace 
almost the entire bulk of the muscle. 

In the palpation of the cervical regions, in some cases, 
we find it almost impossible to gain any intelligent knowl- 
edge of the relation and alignment of the cervical vertebrae. 
The following methods may be used: 

1. Palpation of centrums. 

2. Three fingers for atlas. 

3. Palpation of tender nerves. 

4. Palpation with head flexed. 

5. Two fingers for spinous process. 

6. Three fingers for spinous process. 

7. Palpation with patient lying on back. 

1. Palpation of Centrums. — This is easily done 
while the patient sits in an upright position. 

Standing behind the patient, the operator buries his 
fingers in the soft tissues of the front of the neck in front 
of the sterno-cleido muscles. 

By a gentle pressure of a palpating nature, the fingers 
may be brought in close proximity to the bodies of the 
cervical vertebrae. 

By a gliding movement up and down the neck, we are 
enabled to detect any nonalignment of the centrums of 
these vertebrae. 

Any undue prominence of the body of any vertebra 
would indicate contractions of sufficient extent to produce 
malalignment of the vertebra, and a consequent inter- 



Palpation. 355 

ference with the nerve supply from this region. The 
method of adjustment of such lesions is described in the 
chapter on Methods of Cervical Adjustment. 

2. Three Fingers for Atlas. — The atlas may be 
palpated with the most accuracy by the use of three 
fingers. 

The palpation of the atlas, however, must be of the 
transverse processes wholly, as it has no spinous process. 

Position. — The patient should sit erect, while the 
operator stands behind. 

The tip of the forefinger of each hand is placed against 
the mastoid prominences, while the second fingers are 
placed in contact with the transverse processes of the 
atlas. 

The third, or ring fingers, are placed in contact with 
the transverse processes of the axis. 

By making forward and backward movement of the 
head, we should be enabled to detect any lateral condition 
of the atlas, or any anterior or posterior condition of the 
transverse process of the atlas, on one, or on both sides. 

3. Palpation of Tender Nerves. — By a gentle 
penetrating pressure over the spinal exit of the cervical 
nerves, we are enabled to elicit tenderness, which is a 
positive sign of slight impingement. 

Palpate both sides of the neck back of the sterno- 
cleido-mastoid muscles for the detection of tender nerves. 

4. Palpation With Head Flexed.— Owing to the 
anterior curvature of the cervical region, we find the 
spinous processes approximated and difficult to palpate 
while the head and neck are held in the normal position. 

The third spinous process is under, and almost 
covered by the large and heavy process of the axis, so 
that it is impossible to palpate it in most cases when the 
neck is in the normal position. 

When the head is flexed decidedly forward, with the 



356 Spondylo-symptomatology. 

chin resting upon the sternum, we have a separation of 
the spinous processes of the cervical region. They not 
only separate, but become more prominent, so that by 
palpation we may be able to detect any malalignment of 
the spinous processes of the cervical vertebrae with com- 
parative ease. 

5. Two Fingers for Spinous Processes. — While 
the head is flexed in this way, two fingers of one hand, or 
one finger of each hand, may be used to palpate the 
interspaces, and also the condition of the alignment of 
the spinous processes. 

It is almost impossible to have the spinous process 
of the cervical vertebrae sufficiently manifest to enable 
us to get three fingers against them, and besides the 
sense of touch is less acute in using three fingers than 
when using two. The use of two fingers, then, in the 
palpation of the spinous processes of the cervical vertebrae, 
is decidedly preferable to the use of three. 

6. Three Fingers for Spinous Processes. — By the 
use of three fingers the palpator hopes to determine the 
relative size of the interspaces between the spinous 
processes and the condition of their alignment. 

The method consists of placing the tips of three 
fingers upon the tips of three consecutive spinous pro- 
cesses, and then by observing the distance between the 
fingers, he tries to estimate the distance between the 
spinous processes. 

In some necks, when the spinous processes are quite 
prominent and the neck is decidedly flexed, the three 
fingers may be used against the sides of the spinous 
processes, and by this means it is hoped by some to 
determine their proper alignment. 

We consider this method of procedure very inaccurate, 
and a very poor way of palpating the cervical spinous 
processes, but we notice this method appears to be 



Palpation. 357 

especially attractive to those who wish to be abnormally 
at variance with every normal procedure. - 

7. Palpation With Patient Lying on Back. — The 
cervical vertebral spinous processes may be palpated 
with the patient lying in the dorsal position, with more 
accuracy than in any other attitude. 

Position. — The patient lies upon the back, while the 
operator stands at the head. 

The patient's head is raised from the table, so as to 
flex the neck and to make the spinous processes prominent 
because of the backward curvature of the cervical spinal 
processes. 

In lifting the head, the patient is inclined to assist 
the palpator, and this will tense the flexor muscles of the 
anterior portion of the cervical region, while the extensor 
muscles are out of commission, and for this reason they 
are soft, flexible, and can be palpated with much greater 
ease; whereas, in the sitting posture, when the head is 
thrown forward, the posterior muscles of the neck are 
in action to a greater or less extent, and in that state of 
contraction in which they are thrown to help support 
the head, they form a decided resistance to the palpating 
finger. This is all overcome by placing the patient in 
the dorsal position upon the table. The operator, by 
taking a finger of each hand, can palpate the spinous 
processes with decided accuracy. In this way we may 
easily also palpate to determine the alignment of the upper 
three thoracic vertebrae with almost absolute accuracy. 

When we determine the position of a spinous process, 
we may pass the fingers from the one located to the one 
immediately above it. In doing so, we detect the size of 
the interspace, and can also detect any later condition 
or lack of proper alignment of the spinous processes. 

Passing consecutively from one spinous process to 
another, from the upper thoracic up through the cervical 
region, we are enabled to detect any variation of the size 



358 Spondylo-symptomatology . 

of the interspace, or any deviation of the spinous pro- 
cesses from proper alignment that may exist, with more 
ease and accuracy than by any other method. 

A little practice with this method of palpation will 
certainly make a person very expert in detecting any 
lesions of the proper relation and alignment of the spinous 
processes of the upper thoracic and cervical vertebrae. 



CHAPTER VI. 
NERVE TRACING. 

NERVE tracing is the art of following, by palpation, 
a tender nerve from its spinal origin to some 
inflammatory or pathological lesion or zone, or 
the act of tracing a tender nerve from an inflammatory 
zone back to its spinal exit. 

A nerve may be easily traced if it is tender and so 
situated that we may readily reach it when palpating. 

In order that we may be enabled to do nerve tracing, 
the nerves of necessity must be supersensitive. That a 
nerve must be supersensitive, we must have some kind 
of im pingement of that nerve ; or some kind of mechanical 
interference affecting its cellular integrity. Such a condi- 
tion of a nerve is produced ordinarily by some inflamma- 
tory process of a greater or less degree in the zone that 
is supplied by the nerve or by slight impingement where 
it make its spinal exit. 

If the excitability of a nerve is destroyed by reason 
of heavy impingement, or by reason of continued impinge- 
ment, or by reason of an occlusion of the nutrient vessels 
supplying the spinal centers from which the nerve comes, 
it will then be impossible to trace it. 

In the case of lack of sensibility on the part of a nerve, 
we are unable to take advantage of nerve tracing to 
enlighten ourselves as to the location of spinal lesions; 
hence we must look to other spinal symptoms to guide 
in making adjustments for the relief of those nerves that 
are nonexcitable or lack sensibility. 

We experience no difficulty whatever in tracing 
nerves in recent lesions or pathological processes that 
are attended with inflammation as in the case of boils, 
carbuncles, etc. The existence of pain shows that the 

359 



360 



Spondylo-symptomatology. 




An illustration of the tender region in a case of pericarditis. Straight 
lines show the location of the tender nerves, and the x shows point not 
tender. Nerves come together, and trace to one spinal foramen. 



Nerve Tracing. 361 

nerve is alive and sensitive, and in such cases we have 
no difficulty whatever in tracing the nerve supplying the 
part, from the zone of the pain, back to its spinal exit. 

We also note that pain, or any inflammatory process 
in any zone, will, by reflex contraction, cause tenderness 
of the spinal nerve supply to the part affected. In case 
of bacterial infection, and especially after the stage of 
incubation, and after the production of toxins, which act 
as powerful nerve excitants, we will have reflex con- 
tractions, spinal nerve and muscular tenderness, and 
these conditions enable us to do nerve tracing, especially 
the tenderness of the nerve. 

Nerve tracing is a method of examination and diag- 
nosis that is, or should be, used very extensively by all 
who practice the science of spinal adjustment. It is a 
most interesting and fascinating method of examination. 
It is also very instructive, because of the light it gives as 
to the etiological importance of spinal lesions in the 
production of disease and the location of the spinal 
lesions, that they may be corrected. 

It is very convincing to the patient on whom the 
tracing is made, as it demonstrates to him the connec- 
tion between the deranged function and the spinal 
lesions or spinal interference with the integrity of the 
nerve supply. Nothing is more satisfactory to a patient 
than to trace a nerve from any zone of soreness, inflam- 
mation, or pain in any part of the body, in which 
there exists any pathologic process, back to the 
spinal cord, or to its point of exit from the neural canal, 
and then by giving an accurate thrust, removing the 
interference with the nerve, re-establish normal function. 

If we trace nerves to the spinal exit where they are 
impinged, and where pain is produced, we certainly are 
enabled to do a great work by relieving humanity. In 
the work of relieving pain, we are permitted to do suffer- 



362 



Spondylo-symptomatology . 




Illustration showing spinal connection of the tenderness palpated in 
front via a tender tract traced by palpation. Relief of this nerve was 
effected by a thrust, and the trouble entirely relieved. 



Nerve Tracing. 363 

ing humanity good, and such work as even the angels 
might be jealous. 

If, after you have located the spinal origin of a nerve, 
supplying a pathological zone, you by a thrust relax the 
contractured ligaments of the musculature of that seg- 
ment of the spine, you relieve that nerve, and in this 
way relieve the pain and tenderness, this is a most con- 
vincing procedure and also a satisfying work that you 
can do for the patient. 

Points to Consider in Nerve Tracing: 
I. Methods of holding fingers. 
II. Methods of following a nerve. 

III. Methods of tracing from spine. 

IV. Methods of tracing toward spine. 

V. Locating tender points along nerves. 
VI. Tracing of the peripheral nerve rami. 

VII. Unexplainable nerve tracings in rare cases. 

I. Methods of Holding Fingers.— We trace nerves 
by palpation, and it is often necessary to do so by deep 
palpation, which necessitates the use of considerable 
pressure, that we may be enabled to elicit the tenderness 
of the nerve and determine its tract of continuation. If 
we palpate with our middle finger, we can possibly do 
so better because of a better muscular pad on the end of 
this finger, than there is on the first finger or thumb. By 
training, we may develop the sense of touch very greatly. 

When we find it necessary to do deep palpation with 
the tip of the finger or continuous palpation for some 
time, the finger will need some support to prevent the 
occurrence of muscle tire and exhaustion. 

First, we support the palpating finger to increase its 
strength, and second, we support it to prevent muscle 
tire, which may soon come on with continuous work. 
The best method of holding the finger is by placing the 
first finger on the dorsal surface of the middle finger, 
and by placing the ball of the thumb against the palmar 



364 



Spondylo-symptomaiology. 



surface of the middle finger. In this way we can get a 
good substantial support for the middle finger, which is 
the one we should educate for use in palpation and 
train to continued use. 

It is not necessary to hold the finger grasped and 
supported tightly at all times, but when pressure is made 
in palpating the support may be tightened, and when 
we lessen the pressure the support may be lessened, and 
the repeated alterations in the amount of pressure used 
in supporting the palpating finger will help to prevent 




Illustration showing manner of supporting the palpating finger in case 
of nerve tracing for any length of time. 



Nerve Tracing. 365 

muscle tire, both of the palpating finger and the support- 
ing thumb and finger that is being used. 

After the palpating finger has been thoroughly 
trained, its sensitiveness will be greatly increased, and 
you may trace nerves with a great deal more ease and 
certainty than without training and practice. When 
you have located a tender nerve, either at its spinal 
origin, or at a point approximate to the zone of inflam- 
mation, then you must, in a systematic way, follow the 
nerve either back to the spinal origin, or from the spinal 
origin to the pathological zone. 

II. Methods of Following a Nerve. — When we 
have discovered a tender point in a nerve track by 
palpating with the second finger, we should next make 
pressure at a point in the direction we would judge the 
nerve is extending. If we fail to place the finger on the 
tender nerve as we press a half or one inch further along 
on what we suppose to be the route of the nerve, then 
we should place the fingers to either side, and by palpating 
around in a half -moon shape we will again pick up the 
track of the tender nerve. In this way, step by step, we 
may follow the nerve from one of its extremities to the 
other. 

Sometimes, that we may be enabled to know from 
whence, and by what route we have traced a nerve, we 
find it necessary to mark the tender points. A straight 
line running parallel with the nerve immediately over 
the tender points, will give a picture of the course of the 
nerve on the outside of the body after the tracing has 
been completed. 

There are clinical cases in which, in tracing a tender 
nerve from a pathological or inflammatory zone back 
to the spine, we will find that the nerve will branch, 
or the tender track may be traced to two different points 
of the spinal column. This is probably because two 
adjacent organs are involved, or because a nerve supply 



366 



Spondylo-symptomatology. 




Illustration showing nerve tracing made in case of rheumatism on the 
front side of the arm. 



Nerve Tracing. 367 

from two segments of the spine is given off to the same 
pathological zone and have become involved. 

In tracing nerves we sometimes find that they will 
pass under a bone which will render the palpation of 
the tender nerves impossible, and in such cases it will 
escape the impression of the palpating finger. This is 
true under the scapula and under the clavicle, and also 
in other parts of the body. If the nerve passes under a 
bone or tissues through which we cannot elicit its tender- 
ness, we may be enabled to find the spinal origin of that 
nerve by tracing it as follows: 

Trace the nerve to where it goes under the bone. On 
the other side, where you suppose the nerve may come 
from under the bone, again try to pick up the tender 
nerve, by palpating all along the edge of the opposite 
side of the bone. There will be no trouble in picking 
up the track of the tender nerve again, and then it may 
be traced on to the point of its spinal origin and relieved. 

III. Methods of Tracing from the Spine. — In 
tracing a nerve from the spine to any pathological area 
in which there is an inflammatory condition, we will 
begin at the spine, and by palpating the tender nerve 
at, or near its exit from the neural canal, and then step 
by step we may follow the tender nerve as described 
above, until we reach the pathological zone. 

While nerves may be traced in this way, our experience 
is that it is not the most satisfactory way of tracing a 
nerve, for the reason that sometimes mere pressure 
upon a tender nerve track may allay the tenderness of 
the nerve or benumb it so that it cannot be traced further. 
Palpation or pressure of a nerve will affect the distal end 
of the nerve, and for that reason it is sometimes difficult 
to trace a nerve from its spinal origin to its peripheral 
ending. 

IV. Methods of Tracing Nerves Toward the 
Spine. — The method of tracing the nerve to the spine 



368 



Spondylo-symptomatology. 




Illustration of the nerve tracing made in case of rheumatism, on back 
of arm, from elbow to the spinal origin of the nerve. 



Nerve Tracing. 369 

consists of first locating a point on the track of the tender 
nerve near the inflammatory area. We should avoid 
palpating over the tender zone of the pathological pro- 
cess. Palpate back a short distance, and toward the 
spinal origin of the nerve supply to the inflammatory 
zone. 

When you have located the tenderness in the track 
of the nerve supplying the pathological zone, then 
follow it step by step until you reach the spinal origin 
of the nerve. This can be done satisfactorily and with 
ease, according to the amount of inflammation in the 
zone from which we are tracing. While we are tracing, 
should the pressure upon the nerve benumb its sensi- 
bility, only the distal end will be affected. We may 
continue our tracing on toward the spine, as the proximal 
end is not so much influenced by any pressure or palpa- 
tion of the more distant portions of the nerve. 

There are many cases that can be traced from center 
to periphery better than from periphery to center, and 
in such cases we should trace according to the conditions 
and the circumstances. We often find that the mere 
act of tracing a nerve may relieve pain, and that pressure 
upon the nerves at their spinal origin, will result in 
temporary relief in many cases. 

V. Locating Tender Points of Nerve. — There is 
another very important point that we have discovered 
in our work of tracing. 

As we trace a nerve from its spinal origin to the 
region of some pathological zone, we will often locate 
certain tender points along the nerve that will excite a 
pain which is referred directly and specifically to the 
pathological zone. For example: If we trace a nerve 
from the lumbar region down to a boil on the knee, we 
will find spots along the track of that nerve that will 
excite a sharp and decisive pain that will be referred to 
the location of the boil. We find two, three, or more of 



370 Spondylo-symptomatology. 

these sensitive points along the track of the nerve in 
many cases of nerve tracing. 

We have noticed in tracing tender nerves to the eye 
that we find certain tender points, which, when pressed 
by the palpating finger, will cause a decided sensation 
to be felt directly in the eye. The irritating sensation 
that will cause a sense of pain to be felt because of the 
tenderness of the nerve will carry a transmission of the 
impulse, not to the zone of the pressure but to the end 
of the afferent nerve; consequently the sensation is felt 
in the eye. 

VI. Tracing of the Peripheral Nerve Rami. — 
Nerves, or the branches of nerves that go to internal 
viscera or organs, cannot be traced, because they are too 
deep to be palpated, but there is one important fact 
that will help us in these conditions to correctly deter- 
mine the location of the etiological spinal lesion. 

If a nerve is tender, usually or always all the branches 
of that nerve are tender, and if we cannot trace a nerve 
to the inside of the trunk or cavity to the organ affected, 
we may be able to trace a peripheral branch of that same 
nerve back to its spinal origin. 

We had a very interesting clinical case in our office 
at one time. An allopathic physician came in and 
requested the writer to stick some adhesive strips over 
his ribs, over the right hypochondriac region. He felt 
that this would tend to hold the ribs more stationary so 
that he would not feel so much pain during inspiration 
and expiration. 

We suggested to him that we might relieve that pain 
by relieving the nerve that ramified the painful zone. 
The doctor remonstrated by saying that there was nothing 
wrong with bis spine whatever, and that the trouble was 
all in the front and lower part of the chest cavity. 

We made a careful tracing in this case. First, we 
found a tender nerve track between the zone of the pain 



Nerve Tracing. 



371 




Illustration showing a nerve tracing in a case of pleurisy. Front view. 



372 Spondylo-symptomatology. 

and the spine, but while so doing, were repeatedly told 
that there was nothing wrong with the nerve and nothing 
wrong with the spine, but when we found the tender 
nerve he flinched and changed his mind as to the spinal 
nerve being involved. 

We made a careful tracing back to the origin of the 
seventh thoracic spinal segment on the right side. Reliev- 
ing this nerve did not relieve the pain. Another tender 
track was followed to the point of the third thoracic 
nerve exit on the right side. A thrust was then given 
for the relief of the third nerve that was tender, and we 
thus overcame the contraction of the spinal musculature 
where it made its exit from the spine. While the first 
did not give absolute relief, it did produce quite a decided 
effect, but the second thrust gave absolute relief, and thus 
another man was convinced of the connection between 
pain and muscular contraction of the spinal column. 

In this case, however, we could not trace the nerves 
to the internal organs that were involved, and there was 
no trouble with the external musculature of the chest. 
Our tracing, then, must have been wholly that of follow- 
ing the peripheral nerve branches. When we trace 
peripheral nerve branches, we can most assuredly trace 
to the proper point or locality of the spinal lesion where 
we should give relief by adjustment. 

This man was no doubt surf ering with both an involve- 
ment of the pleura and liver, which is just beneath the 
diaphragm, and no doubt there was trouble with the 
diaphragm, which intervened between the liver and 
pleura. 

VII. Unexplainable Nerve Tracings in Rare 
Cases. — We have made many nerve tracings, and some 
of them we have not been able to harmonize with our 
knowledge of the anatomical arrangements or of the 
distribution of the nerves that we traced. 

We are puzzled sometimes to know why we find a 



Nerve Tracing. 



373 




Illustration showing the spinal origin of the nerves impinged, and causing 
the pain in the liver, pleura, and diaphragm. 



374 Spondylo-symptomatology. 

tender nerve track running in the direction that we do, 
but there is one thing that we notice: That however 
erratic a nerve tracing may be, if we trace carefully we 
are able to relieve the trouble about which we are con- 
sulted. We will narrate in this connection examples of 
two tracings that to us seem to be unreasonable and 
unexplainable : 

A lady patient came to our office suffering intensely 
with rheumatism, and the seat of the pain seemed to be in 
the glenoid cavity. She was unable to raise her arm or 
to use it, or to move it to dress herself. She had thrown 
a covering over her shoulders and came to our office for 
relief. 

After a hurried examination and nerve tracing, we 
found a very tender nerve which we traced to the second 
thoracic region. A thrust to relieve the contraction or 
lesion at this point, gave absolute relief. She dressed 
herself and returned to her home in perfect comfort. 

After two days she returned again with a second 
attack of neuralgic or rheumatic pain. This time it was 
under the clavicle on the right side. The pain was so 
intense that it involved the use of the right arm, and 
again she could not dress herself, to come to our office, 
but had thrown a covering over her shoulders. We 
expected to again trace a nerve directly to the spinal 
column, but to our disappointment we could elicit no 
tenderness between the point of the pain and the spinal 
column. After carefully investigating a few minutes, we 
discovered a tender track that passed downward and 
backward in the axillary region, and the tracing then was 
made along nearly a straight line to the first lumbar. 
A thrust was given at this point, but at no other. The 
result was immediate, and absolute relief was given. 

Now, we would be pleased if some anatomist would 
come forward and explain the connection that existed, 
and how we were enabled to relieve a pain under the 



Nerve Tracing. 



375 




Illustration showing the origin and tracing of nerves, which we relieved 
in a case of blindness, and by so doing we restored the power of sight. 



376 Spondylo-symptomatology. 

clavicle as low down as the first lumbar vertebra that 
was felt so distinctly, and to be so painful, under the 
clavicle. 

In concluding this chapter, we would call your atten- 
tion to one more point, and that is, when a nerve is 
tender at all, it is tender throughout its entire length; 
consequently any tender nerve will be tender at or near 
its spinal origin in every case, provided the heavy muscles 
hinder palpation. 

For this reason a careful palpation of the nerves at 
or near their spinal origin, may enable us to locate the 
cause of pain at some distal portion of the ramification 
of that nerve in most cases, and if we relieve all the 
nerves that are tender at their point of exit from the 
neural canal, we will be able to relieve all pain anywhere 
in the body. This we have demonstrated time and time 
again, but this fact sometimes leads people who do some 
spinal adjustment into the careless habit of omitting 
nerve tracing. 

Instead of tracing nerves as they should, they simply 
examine for tender nerves along the sides of the spinal 
column, and adjust for their relief, and often in this 
way when they give relief, they do not know from what 
source the relief came, which removed pain in the certain 
peripheral point. 

There are many strange tracings that are easily 
understood if we thoroughly understand our anatomy. 

We had a remarkable case, that will illustrate this 
fact, in Pittsburg, Pa., when an M. D., who had suffered 
for sixteen years with a pain over the right hypochondriac 
region every time he would draw a full breath, came 
forward as a subject for nerve tracing. We expected at 
first when we located the tender zone to trace the nerve 
from this region directly back to the spine following the 
intercostal space and nerves. For the first inch and a 
half, the tender nerve did run toward the spine, following 



Nerve Tracing. 



377 




Illustration showing the front view of the nerve tracing made in the 
case of blindness, and the termination of the nerves at the orbit of the eyes. 



378 Spondylo-symptomatology. 

the intercostal space, but suddenly the tender track 
took an upward direction through the axillary region, 
and in front of the shoulder under the clavicle, and thence 
back tD the origin of the sixth cervical nerve upon the 
same side of the painful zone. 

Now this at first seemed to be a very peculiar tracing. 
If we examine the ramification of the long posterior 
thoracic nerve, we have a solution of this problem. We 
proved the correctness of this tracing by relieving the 
articulations between the fifth and sixth cervical vertebrae, 
and this gave instant relief to all trouble over the right 
hypochondriac region. The doctor could take a full 
breath with absolute comfort. The relief was permanent 
except it was caused to recur a few days later by a mal- 
adjustment, but this was quickly corrected. 

Nerve tracing and relieving tender nerves by a thrust 
to relieve the spinal lesion will convince any doubting 
Thomas possessed of reasonable intelligence, of the 
importance and potency of spinal adjustment, the less 
intelligent and prejudiced medical practitioners excepted. 



CHAPTER VII. 
SPONDYLO-DIAGNOSIS. 

THE word "spondylo" refers to a vertebra or to the 
spine. 
Spondylo-diagnosis, then, refers to the diagnosis 
of disease by the detection of spinal lesions involving 
the integrity of the nerves to certain organs or zones. 

That we may be able to diagnose by palpation of 
spinal lesions, it is very necessary that we possess a 
thorough knowledge of the nervous system, both as to 
its ramifications and the nature of the function produced 
by the nerves from the different spinal segments. 

It is also necessary that we have a good and competent 
knowledge of the pathological processes to which each and 
every organ is liable, that we may judge the result of 
the interference with any nerve supplying an organ or 
part of the human organism. 

Spinal diagnosis is helpful, sometimes, in determining 
which of two organs is involved. In differentiating, if we 
have a pain in the region of the diaphragm, we may be 
at a loss to know whether or not the lesion is of the pleura 
above the diaphragm, or of the liver, or of some other 
adjacent organ beneath the diaphragm. By nerve pal- 
pation we may often make the necessary differential 
diagnosis to determine which organ is involved. 

The most direct nerve supply to the pleura comes 
from the upper part of the thoracic region of the spinal 
column, while the nerve supply to the organs just beneath 
the diaphragm, come from the central section of the 
thoracic portion of the spinal column. In such a case, 
the differential diagnosis is always very easily accom- 
plished. The tender nerve will enable us to decide 

379 



380 Spondylo-symptomatology. 

whether the pathological process is above or below the 
diaphragm. 

The lungs occupy both sides of the chest, and the 
tenderness of the spinal nerve supply, especially at the 
point of exit of the nerve from the neural canal which 
supplies the lung, will enable us to determine which lung 
is involved. If the nerve that is tender is on the right 
side then we may know that the right lung is involved. 
If the nerve on the left side is tender then we may know 
that the tenderness is because of involvement of the 
left lung. 

We may be able to make a differential diagnosis 
between appendicitis and ovaritis owing to the fact that 
these organs are supplied by different spinal nerves, 
although these organs receive their principal nerve supply 
from adjacent segments of the spinal cord. 

A knowledge of spinal diagnosis is very important 
and very helpful to a surgeon in differential diagnosis. 
We know, that often before a surgical operation, the 
diagnosis is not clear as to what organ is involved in 
many cases. Often exploratory incisions are made to 
determine what organ is involved, and the wisest are 
often unable to determine before the incision is made 
what organ is involved, hence mistakes are made. Such 
mistakes will always be unavoidable while the surgeon 
continues to use the ordinary methods of diagnosis. With 
a thorough knowledge of spondylo-diagnosis there is no 
doubt that much light may be thrown upon a great 
many cases, and in this way surgery may be made 
much more scientific than it has ever been in the past. 

We refer you to an example that we have noticed in 
another connection, that will emphasize the importance 
of a thorough knowledge of spinal lesions, and of differ- 
ential diagnosis by an interpretation of these lesions. 
The case was that of a young lady who was to be operated 



Spondylo-diagnosis. 381 

upon for gall stones, when her trouble was that of pleurisy. 
(See Chapter X., Part Two.) 

The Griffith Bros., of Northern Europe, made a close 
study of the relation existing between spinal lesions and 
the manifestation of the accompanying disease. This has 
been referred to in a previous chapter, but the wonder is 
now, why has not this line of thought been taken up and 
taken advantage of long before this time. Probably 
there has been no greater auxiliary to correct differential 
diagnosis ever discovered by any one or that may be used 
by any doctor or surgeon than spinal diagnosis. 

A true diagnosis cannot be made from the spine, as 
is claimed by many, and there are several reasons why 
an absolute diagnosis is impossible from spinal palpation. 
Notwithstanding the above there are certain facts that 
we may determine by spinal palpation and that can 
not be determined by any other method of diagnosis. 

In order to bring before you what we can, and what 
we cannot determine by spinal palpation, we will call 
your attention to the difficulties met with in spondylo- 
diagnosis : 

1. Abnormal function variable. 

2. Different nerves to viscerse. 

3. One nerve to different viscerse. 
Abnormal Function Variable. — Abnormal function 

may vary principally because of the fact that different 
pathological processes may occur within an organ and 
we cannot determine the nature of the pathological 
lesions by spinal palpation. Any pathological process in 
which there is any inflammatory condition, would be 
indicated by tenderness of the spinal nerve supply to the 
pathological zone, but the nature of the lesions would 
be a matter of conjecture and consequently we cannot 
correctly judge the nature of the functional derangement. 
To illustrate further, we may have different lesions of 
the kidneys, of the stomach and also of the bowels. We 



382 Spondylo-symptomatology. 

may know that a certain nerve supplying an organ, is 
interfered with because upon palpation we find that it 
is tender, or, we may know that it lacks sensibility, due 
to a partially paralyzed condition, and yet we may not 
be able to know the nature of the derangement that is 
produced by the interference with the nerve, and unless 
we may be able to determine the pathological derange- 
ment, we have not made a perfect or complete diagnosis, 
or in other words have made no diagnosis except to 
determine that there is interference with the integrity 
of the nerve supply to an organ and consequently some 
derangement of function. 

Should we palpate the spinal nerves at, or near their 
spinal exit which supply the kidneys, and find them 
tender, we would know there was an inflammatory 
condition of the kidneys, but we would not know just what 
the nature of that kidney trouble was. We may say 
positively that the patient has derangement or functional 
disorder of the kidneys, but it would require a chemical 
and miscroscopical examination to determine with any 
degree of accuracy the pathological lesions and functional 
derangement that exist in the renal organs. 

If we are familiar with the functions of the different 
segments of the spinal cord, and understand which have 
the vasoconstrictor and which permit vasodilator action, 
then we may judge in a way the nature of the lesion of 
the organ supplied from that special spinal center which 
is involved. 

We find this difficulty in spinal diagnosis: The same 
nerve will ramify different organs. It may produce one 
effect upon one organ, and a different effect upon another, 
and this makes the spinal diagnosis a matter of conjecture 
in a large measure. 

It would be hard indeed to determine whether or 
not one or all of the organs influenced by a nerve are 



Spondylo-diagnosis. 383 

involved, unless there is a lesion of some of the other 
nerves affecting one of the organs. 

Several different nerves help to furnish the nerve 
supply to each and every organ or viscerse. For this 
reason, although we may know of the functional derange- 
ment of an organ, we may be unable to determine what 
portion of the nerve supply is involved causing the 
pathological conditions. 

We should take into consideration both the subjective 
and objective symptoms to aid us in making a complete 
and perfect diagnosis. We should analyze the secretions 
from the kidneys also as an auxiliary to a correct diagnosis 
of the nature of their functional derangement. The 
miscroscope is necessary in many cases in determining 
the presence of bacteria, animal parasites, and the 
existence of pathological tissues, etc. 

For the above reasons, we take the position that 
diagnosis cannot be made from the findings of spinal 
palpation alone. Other auxiliary methods of diagnosis 
are very necessary and give much additional light as to 
the correct diagnosis of disease and its processes. Spinal 
diagnosis, however, taken alone, is probably one of the 
greatest methods of diagnosis known and practiced 
to-day. 

Diagnosis from the eye is practiced successfully by 
a few, and we are sure that much may be determined by 
a close, critical examination of the eye. This, however, 
requires close study and patience. Some people diagnose 
from the face, teeth, etc. They give special attention 
to the diathesis of the patient. We believe that all 
auxiliary methods of worth should be known and used 
by the person who would make a good diagnostician. 

There has been considerable deception worked upon 
the public by those who profess to diagnose all diseased 
conditions by spinal palpation. Many have appeared to 
be wiser than their fellow men, when, as a matter of fact, 



384 Spondylo-symptomatology. 

they could not make a diagnosis. To illustrate how this 
is worked, we will give the following example: 

One day a lady called at my office and remarked: 
"Doctor, I understand that you can tell what is the 
matter with a person without asking a question." I 
at once corrected her mind as to such an extravagant 
claim on my part. She desired that I should make an 
examination, which I did, and upon palpation of the 
spine, I found certain lesions, and told her that she had 
an involvement of six different portions or viscera of her 
body, and enumerated them. This I did by finding an 
involvement of nerves at six different locations along the 
spine, which segments gave most of the nerve supply to 
the organs that I mentioned as being involved. 

For example: There was an involvement of the tenth 
thoracic, and I told her she had kidney trouble, there 
was an involvement of the principal nerve supply to the 
stomach, and from this I told her she suffered with stom- 
ach trouble; she had tenderness of the nerves in the 
lumbar region, and from this I told her she had female 
trouble, and because of the lack of sensibility and inter- 
ference with the second lumbar nerves, I told her she 
was suffering with constipation. 

Now, I really had not diagnosed her case. I had told 
her that certain organs were involved, but she thought 
that I had made an excellent diagnosis. When I asked 
the question if I had told her all of her troubles, she 
replied: "Yes, you have told me all that is wrong with 
me." I then asked, further, if I had claimed anything 
was wrong, that was not wrong. To this she responded: 
"You have mentioned every trouble that ails me, and 
everything that you have mentioned is true." 

Now, this lady really felt that she had had a correct 
diagnosis, but I knew in my heart that I had not diagnosed 
the case from her spine; that I did not know the nature 
of the female trouble, nor did I know the nature of the 



Spondylo-diagnosis. 385 

kidney trouble; also, I was ignorant of the nature of 
the stomach trouble. I had simply said these organs were 
involved, and the patient had mistaken that for a correct 
diagnosis; she did not know what diagnosis meant, and 
many are practicing this method of diagnosis and thinking 
it is diagnosis, when it is really not diagnosis. 

There is one thing in favor of this method of diagnosis, 
and that is: That deranged function is the direct result 
of nerve interference, and normal functional action of 
nerves will produce normal function and health. 

When we remove all interference with the nerve 
supply to an organ, we re-establish normal nerve function, 
provided structural lesions do not prevent, which is the 
greatest factor on earth in the re-establishment of health, 
and so we can see it makes but little difference what 
the functional derangement is, nor the nature of the 
pathological process, since removal of the interference 
with the nerve supply re-establishes the normal function, 
and in this way restores health to the part and in most 
cases will restore the normal cellular structural arrange- 
ment in a sufficient length of time. 

It is undoubtedly necessary, however, that in diagnosis 
we should determine the nature of the kidney lesions both 
of the pathological processes and deranged functional 
action, when we can, before treatment, so that when 
the trouble is removed, we will really know what we have 
accomplished. For example: We treat a patient who is 
wearing glasses. After a few treatments the patient does 
not need the glasses any more. The eyesight is perfect 
without glasses, and they become a detriment to vision 
instead of an assistance. Now, if we have made no test of 
the refractive errors of the eye, we do not know what we 
have done for our patient. 

Now, suppose we have a case of Bright's disease or a 
case of diabetes. We say to our patient that he has 
kidney trouble. We so determine because of the involve- 



386 Spondylo-symptomatology. 

ment of the kidney nerves. The patient gets well under 
our treatment, but we do not know what we have accom- 
plished. If we have made a microscopical examination 
and a chemical test of the kidney action, at the beginning 
of our treatment, then we may know what we have 
accomplished by our treatment when recovery of the 
normal function is complete. 

We are longing for the day when the science 
of Chiropractic-Spondylotherapy and other rational 
methods of treatment will be in the hands of the more 
intelligent and better educated class of people, but this 
will not be until the laws of our country regulate the 
practice of spinal treatment, as well as other methods. 

In spinal diagnosis we are enabled to determine, to a 
certain extent, the location of lesions, by an examination 
of nerves of certain segments of the spine. We might 
mention the following spinal segments, and consider 
briefly what may be indicated by lesions affecting the 
nerves from these lesions : 

1. Upper cervical. 

2. Middle cervical. 

3. Upper thoracic. 

4. Middle thoracic. 

5. Inferior thoracic. 

6. The upper two lumbar. 

7. The lower three lumbar. 

Upper Cervical. — By the upper cervical, we refer 
to the first, second, and third pair of cervical nerves. 

If we find tenderness upon palpation of the upper 
cervical nerves, we would think of lesions affecting the 
ears, eyes, scalp, and also the nasal passages. These 
upper cervical nerves influence directly certain cranial 
nerves, by joining them or their peripheral branches in 
some terminal ganglia of the sympathetic and thus 
assist in supplying some of the organs of the head. 



Spondylo-diagnosis. 



387 




Illustration showing the muscles of the neck, whose contraction will 
cause approximation of the atlas and the occipital bones, and impingement 
of the suboccipital nerves. 



If we find subluxation, contraction, or interference 
with the first pair of cervical nerves, we may judge that 
there may be a disturbance or occlusion of the circulation 
of the posterior portion of the brain, because any con- 
traction at this point interfering with the nerves, would 
also interfere with the corresponding intervertebral 
arteries and veins. If we then have an involvement of 
the nerves contained in this sheath, we will also have an 
involvement of the vessels which supply the circulation 
to the posterior lobes of the brain, and as certain centers 
are situated therein, we will have certain functional 
disturbances. 



388 Spondylo-symptomatology. 

One would be a disturbance of the optic nerves, which 
arises in the cortical portion of the occipital lobes. In 
such cases, the eyes grow tired and heavy, and you may 
suffer with amblyopia. 

We notice associated with lesions of the first pair of 
cervical nerves, that the ear wax is not formed in the ears, 
normally. Lesions of the suboccipital nerves have to do 
also with the failure of function of hearing. 

We also have, because of interference with sub- 
occipital nerves, an interference with the nerve supply 
to the greater portion of the scalp. The suboccipital 
nerves pass upward and forward, and upon reaching the 
forehead, they pass downward to the eyebrows. As a 
result of impingement of the suboccipital nerves, we often 
have neuralgic headaches. 

It has always been thought that the tri-facial nerve 
was responsible for tic-douloureux, but we find it is an 
impingement of the upper cervical nerves that is responsi- 
ble for the trouble, and not lesions of the fifth pair of 
cranial nerves as formerly supposed. The tri-facial nerve 
cannot be impinged and it is only the cervical nerves 
joining it that may be interfered with by impingement. 
Nasal catarrh is associated with tenderness of the third 
and fourth cervical nerves. 

Middle Cervtcal. — In the middle cervical region, 
we have the fourth pair of cervical nerves, and also the 
third and fifth pairs. The range of the disturbance 
that is produced by interference with the middle 
cervical nerves, through various parts of the body, is 
quite extensive. 

1. The upward ramification of the middle cervical 
nerves affect the teeth, gums, pupil of the eye, and optic 
nerve. 

2. The middle cervical nerves also give off the phrenic 
nerves, which pass downward and supply the pericardium, 
pleura, diaphragm, and join in the formation of the solar 



Spondylo-diagnosis. 389 

plexus. They reach as far as the adrenals in their lower 
peripheral ramification. 

Involvement of these nerves interferes with the 
expansion of the diaphragm and chest; consequently 
interferes with the respiration and the circulation and 
quantity of blood in the thoracic cavity. 

When the blood in the thoracic cavity is diminished 
in quantity, we are apt to have a compensatory increase 
in the amount of blood in the cranial region, so we have 
headaches, and other disturbances from the middle 
cervical region. We have barber's itch, and even hay 
fever, as a result of fourth cervical vertebral lesions 
affecting the middle or fourth cervical pair of nerves. 

An M. D. in Denver, Colorado, who has taken a 
course of instruction in spinal treatment, succeeded in 
relieving an attack of asthma by an adjustment of the 
middle cervical vertebra although it was a chronic case 
of several years' standing. 

From this region we have our vasomotor and vaso- 
constrictor influences upon the lungs, and also, to a certain 
extent, upon the heart. For this reason, percussion with 
the hand in case of emergency will sometimes revive 
the patient who is unconscious. This has been taken 
advantage of many times by persons who were aware 
of the vasomotor influences of the nerves upon the organs 
of the chest cavity or because they had an empirical 
knowledge of the beneficial effects of this measure. 

According to Griffith Bros., cervical tenderness is 
associated with headache, nausea or vomiting, facial 
neuralgia, fits of insensibility, and affections of the upper 
extremities. We find this to be true in our experience 
in spondylo-diagnosis. 

Upper Thoracic. — Tenderness in the upper thoracic 
region is associated with bronchial troubles, lung troubles, 
cardiac derangement, and also involvement of nerves of 
this region influence cranial organs by reason of their 



390 Spondylo-symptomatology. 

connection with the cranial nerves through the upward 
stream of the white rami communicantes, and the superior 
cervical ganglia of the sympathetic. 

We have had some interesting cases of pleurisy and 
bronchitis, associated with lesions in the upper segments 
of the spine, and these troubles are relieved by second 
and third thoracic adjustment. One lady who had lost 
the use of her hand, had the normal use of it restored by 
relieving an interference with the third pair of thoracic 
nerves. This seems somewhat unusual. Ordinarily, 
we get more effect upon the arm and hand from the 
second thoracic nerves as they send the intercosto- 
humeral nerves into the brachial plexus and into the 
upper extremities. 

The pleura and apexes of the lungs get a direct nerve 
supply from the third thoracic. We find that the inhibi- 
tory center for the heart's action is in the fourth segment 
of the spine, corresponding in location to the body of the 
second thoracic vertebra, while concussion of the lower 
cervical segments of the spinal cord, say over the seventh 
cervical, has a decided stimulating effect upon the vaso- 
constrictor influence upon the heart and aorta. 

We find that about the second segment we have more 
of a vasoinhibitory influence, so that concussion over the 
first and second thoracic processes of the thoracic region, 
will induce an inhibitory influence upon the heart. 

So, in general, in the upper thoracic region, we would 
diagnose bronchial trouble, pleurisy, lung troubles, and 
troubles of the upper extremities, and by adjustment at 
this point we affect these organs, and it is the proper 
place to relieve cardiac lesions and aortic insufficiency. 
The ciliary muscles of the eyes are controlled principally 
by the upper thoracic nerves. 

Middle Thoracic. — This brings us to the region of 
the center of the great reflex system, which is contained 
principally in the spinal cord. 



Spondylo-diagnosis. 391 

In the center of this region we have the dividing point 
of the two streams of white rami communicantes; one of 
which passes upward, while the other passes downward. 
Here we begin to affect the organs in the center of the 
trunk, the stomach, diaphragm, spleen, liver, etc. 

We also have from this region, about the fourth 
thoracic segment, nerves which excite a direct action 
upon the muscles of the heart. This is a very important 
region, and one in which lesions are common, and in 
which they are more general in their effect throughout 
the different portions of the body. 

In the distribution of the fifth pair of spinal nerves, 
we have quite a peculiarity because of the difference in 
the ramification of these nerves from the two sides of 
the spinal column. The nerves from the left side of the 
spine are supplied to the viscera of the adjacent region 
and excite a vasomotor influence upon the action of the 
stomach, while the nerves from the right side are distrib- 
uted almost wholly to the throat and organs of the head ; 
affecting the eyeballs, tongue, thyroid glands, tonsils, 
throat, etc. 

The sixth pair of spinal nerves are the center of the 
great reflex system, and affect the organs both below and 
above their point of exit from the spine. They affect 
the spleen, liver, and stomach, and other viscera, also the 
general condition of the nervous system. 

Inferior Thoracic. — The lower thoracic nerves 
especially affect the bowels, kidneys, and viscera of the 
central and lower portion of the abdominal cavity. Any 
involvement of the nerves to this region would indicate 
trouble with the omentum or peritoneum, small intes- 
tines, kidneys, supra-renal capsules and other viscera. 

Lesions here would also indicate a lack of tonicity of 
the lungs, heart, and stomach, through their connection 
with the phrenic nerves and through the pneumogastric. 
Because of the downward stream of white rami com- 



392 Spondylo-symptomatology. 

municantes, lesions in this region also have an influence 
upon the pelvic organs. 

Upper Lumbar. — The upper lumbar nerves have 
quite a positive and distinct influence upon the organs 
they ramify and those they affect indirectly. 

The first pair of lumbar nerves have a decided and 
positive vasomotor influence upon the bladder. They 
also affect the lower large intestines. 

The second lumbar nerves influence the inguinal 
canal, the large intestines, appendix, sexual organs, and 
other parts; from this region we may excite a vaso- 
constrictor influence upon the viscera higher up in the 
abdominal cavity by percussion, as, for example, the 
stomach, liver, and spleen may be constricted. 

Involvement of the first and second lumbar nerves 
would indicate bladder troubles, constipation, diarrhea, 
dysentery, appendicitis, hernia, and we may have neu- 
ralgia of the thigh, because these nerves enter into the 
formation of the anterior crural nerves. 

We have associated with these lesions, pain in the 
abdomen, loins, hips, dysury, etc. 

Lower Lumbar. — The lower lumbar nerves enter 
largely into the formation of the great sciatic nerves, and 
they influence the rectum, uterus, and other pelvic 
organs, and from lesions of this region we may diagnose 
female troubles, lumbago, sciatica, rheumatism, rectal 
troubles, and other diseases of this region. Affections of 
the ankles, knees, and other joints of the lower extremi- 
ties, and diseases of the rectum, are influenced largely by 
the fifth pair of lumbar nerves. 

In the above we have given briefly the diagnostic 
indications of lesions in the different segments of the 
spinal column, but have not gone into detail as to the 
specific indications from the involvement of the different 
spinal nerves. This subject will be considered more in 
detail in subsequent chapters in which we consider the 
ramification of the different spinal nerves. 



PART FIVE. 

SPONDYLOTHERAPY METHODS. 

CHAPTER I. 

SPONDYLOTHERAPY METHODS. 

THE word spondylotherapy means, literally, spinal 
treatment. Since our study of spinal lesions, and 
their relation to pathological processes and disease 
in general, we feel the importance of giving special 
attention to spondylotherapeutic methods, as spinal 
treatment is evidently a necessary procedure after having 
a knowledge of why disease exists. 

There are two questions that come up in connection 
with every case of sickness, either acute or chronic: 

1. What is the cause of the sickness? 

2. What is the proper treatment to employ? 

The treatment of disease has been presented from 
almost every standpoint. Not only have we a school 
that depends upon medicine as its main line of treatment, 
but surgery, hydrotherapy, massage, suggestion, Christian 
Science,, and many other forms of treatment have been 
applied for the relief of suffering humanity. 

During more recent years, methods of spinal treat- 
ment, in vogue in some of the Northern European 
countries, have been introduced, developed and prac- 
ticed in the United States. To-day the principal advo- 
cates and practitioners of spinal treatment are those 
who believe in and practice almost exclusively, drugless 
methods of treatment. 

Among the schools of practitioners using the spinal 
methods of treatment, we find the osteopaths, chiro- 
practors, and those who practice mechano-therapy. 

393 



394 Spondyloiherapy Methods. 

There is no doubt that these systems of treatment 
all sprang originally from the Swedish massage methods 
and the Bohemian methods of giving the spinal thrust. 
The brain of the American people must be credited, 
however, with having greatly developed, in many respects, 
these methods of treatment. 

We have but little sympathy for the pseudo, self- 
styled discoverers, and also find that those who have done 
the greatest work in developing these methods of treat- 
ment, are having the least to say, and do not boast about 
it, while those who have boasted of being its developers 
are ignorant of the underlying principles of the science 
of spinal adjustment. 

In this chapter it is our intention to consider some of 
the better and more practical methods of spinal treatment. 
There is a tendency on the part of some to remain in the 
rut and to advocate but one method of spinal treatment, 
namely, the thrust, and but one abnormal thrust; but 
we like the broad platform of some of the medical schools 
much better, as they are not so selfish, and are teaching 
the use and recommending any method for the alleviation 
of the sick, when they are convinced that a method is 
meritorious. However, all doctors are not as broad as 
their professed platform. 

The broad education of the medical men of to-day 
prevents that narrowness that is characteristic of some 
who are so deep in the rut that they can see only one 
system of treatment, and that is spinal treatment, and 
only one method of treating the spine, and that is the 
thrust, and sometimes only one way of giving the thrust, 
as is above stated, and which is of the most absurd 
character. 

We are confident, from an extended experience in 
spinal adjustment, that there are numerous methods of 
adjustment which possess merit, and are very valuable 
to any one who would practice spondylotherapy. There 



Spondylotherapy Methods. 395 

are other methods of treating the spine besides the 
thrust, which are conducive to the restoration of the 
normal condition of the spinal musculature. We will 
enumerate some of the methods of spinal treatment, as 
follows : 

I. Stretching. 
II. Masseuring. 

III. Concussion. 

IV. Sismotherapy. 
V. Thermotherapy. 

VI. Psychotherapy. 
VII. Nerve pressure. 

I. Stretching. — It is a well-known fact that the 
spine settles because of muscle tire as a result of a hard 
day's work. There is no question but that as a person 
grows old, the settling of the spine during the day is not 
entirely overcome by the rest and relaxation of the 
night, and as the result of this, we see the old man or 
the old woman's spine growing shorter. Sometimes the 
intervertebral cartilages of the spinal vertebrae will lose 
one third or more of their average thickness and this 
will cause a corresponding shortening of the spine. 

When the spine shortens, because the intervertebral 
cartilages grow thinner, the intervertebral foramina are 
likewise narrowed; thus we have interference with the 
integrity of the nerve sheath and its contents. 

For all general shortening of the spine, stretching, if 
properly done, is an excellent way of relaxing the tendons 
and increasing the thickness of the intervertebral carti- 
lages. In fact, it is the only way which will accomplish 
results of this kind in a satisfactory manner in a reason- 
able length of time. 

We fully believe that a proper stretching of the spinal 
column from time to time, will prevent the settling that 
comes on with age, and will maintain in the spine the 
proper length and the proper thickness of the inter- 



396 Spondylotherapy Methods. 

vertebral cartilages, and consequently, the proper openings 
of the spinal windows for the exit of the neural sheath 
and its contents. 

We may, by adjustment, overcome a local contraction 
between two adjacent vertebrae and relieve the nerve; 
in fact, this can be done at any segment of the spine, but 
we cannot by the adjustment increase the intervertebral 
cartilages as much or as fast as we can by other methods 
used, especially that of stretching the spinal column. 

Stretching may be done by fastening the feet and 
head of the patient to previously arranged attachments 
upon a horizontal table, and then by separating the 
attachments and bringing a decided tension upon the 
patient, which will affect the spine quite uniformly 
throughout. In this case the weight of the body has 
nothing to do with the amount of tension, but the tension 
is wholly controlled by the extension of the head attach- 
ment from the foot attachment. This is probably a 
more comfortable way of stretching the spine, and is 
therefore the favorite method used by a great many 
people who practice spondylotherapy treatment. 

There are many ways in which we may stretch the 
spine, and of the practical methods that we use in spinal 
stretching, we enumerate the following: 

1. Swaying. 

2. Swinging. 

3. Manual traction. 

4. Bimanual thrust. 

5. Vibrato- traction. 

6. Traction-adjustment. 

7. Longitudinal vibrato-traction. 

All of these different methods may be used, and either 
of them may be advantageous in the treatment of different 
patients. 

1. Swaying. — The act of swaying the spine in such 
a way as to bring into activity the musculature of the 



Spondylotherapy Methods. 397 

side of the spine, will develop the lateral musculature. 
The swaying may be passive or active. There are different 
positions that a patient may assume, and certain changes 
in position that he may make, that will call into action 
the musculature of the spine. There are certain move- 
ments that the operator may give or put a patient through, 
that will bring into activity the musculature of the 
spine, and thus strengthen and develop it. 

Calisthenics, Swedish movements, and all athletic 
exercises that develop the musculature of the spine, are 
beneficial because of the bending or swaying that takes 
place. If a person uses due intelligence in movements 
and thus brings the musculature of the spine into action, 
there is no doubt that he can train and develop himself 
out of certain forms of disease, and also maintain perfect 
strength and agility. 

We will mention a few methods of exercise that will 
bring into action the musculature of the spine, which we 
have found to be very beneficial: 

Stand with the heels together and knees unflexed; 
bend forward and touch the floor in front without bending 
the knees. This movement produces a decided flexion 
of the spinal column, and the patient may have the 
most decided effect upon the lumbar region, or upon the 
thoracic region. Children and young people can easily 
touch the floor without bending the knees. Many people 
of middle age cannot at first reach the floor or reach 
within a foot of it, but if they continue the effort they 
will gradually loosen up the tissues of the spine until 
they can get sufficient relaxation to permit enough 
flexion, to reach the floor. 

A good plan is to stand with the hands raised above 
the head and reach as high as possible; then with a 
swaying movement forward keep the hands above the 
head until you bring them down in contact with the 
floor, while you hold the knees unflexed. If you do not 



398 Spondylotherapy Methods. 

reach the floor the first effort, try, try again until you 
can easily reach the floor. Some become so supple and 
flexible in their spines, as to be able to lay the palms of 
their hands upon the floor. If a person in middle life 
will go through this exercise from three to twenty times 
every morning, he will succeed in keeping the flexibility 
of the spine normal for years. 

Another important movement that can be practiced 
as an active exercise on the part of the patient, is to hold 
the arms extended at right angles with the body. Fill 
the lungs full of air, then rotate the arms and shoulders 
without rotating the hips. This brings a rotary swaying 
movement upon the spinal column, and as the patient 
rotates from right to left and from left to right, each 
time rotating as far as possible, he is bringing into play 
the musculature of the spine. This may be repeated for 
five or ten minutes with most excellent effect. In this 
exercise almost every or any portion of the spine may be 
most decidedly rotated at the will of the patient. 

Rotation may affect mostly the lumbar vertebrae, or 
it may affect the lower, and even the middle portions of 
the thoracic region. In this way the nerve supply to 
the pelvic organs, to the lower bowels, to the kidneys, 
and to the stomach, may be freed of the interference, 
caused by contractured tissues of the spinal column. 

A flexion or swaying of the spine from side to side, as 
the patient stands with his hands upon his hips, brings 
into play the lateral musculature of the spine, and is 
decidedly a beneficial movement for the development of the 
tissues of the spinal column. 

Swaying may be accomplished very easily by the 
practitioner as the patient lies upon the adjustment 
table. A treatment table may be so built that we can 
get decided lateral flexions or swaying of the spinal 
column of a patient with perfect ease. Not only can we 
get this lateral swaying of the spine by using a properly 



Spondylotherapy Methods. 399 

built table, but we can concentrate the effect of the 
principal part of that swaying in any part of the spine 
that we choose. In this way we relax principally the 
musculature of the lumbar, and may affect the lower or 
upper thoracic segments of the spinal column at will. 

This treatment does not take the place of the spinal 
thrusts wholly, but it does relieve the tissues of the 
spine of people who are so sore and tender that they 
cannot stand an adjustment, and is especially good treat- 
ment for old people who need to have their spinal muscula- 
ture gradually relaxed. It is an indispensable method 
on the part of all successful practitioners of spondylo- 
therapy methods, who would make the best success of 
their work. 

2. Swinging. — Swinging is another method of stretch- 
ing the spinal column, and one that is used considerably, 
and one that is especially effective and useful in a number 
of cases. 

Different devices have been manufactured for the 
purpose of swinging the patient so as to bring the weight 
of the body upon the musculature of the spinal column. 
A continuation of the weight upon the ligaments, tendons, 
and other tissues of the spinal column, causes a relaxation 
and lengthening to take place. 

If the head of a patient is placed in a halter and 
supported by a band under the chin and occiput, the 
entire weight of the body may be supported entirely by 
the tissues of the spinal column. The upper segments of 
the spinal column have the weight of the entire body, 
while the lower segments have the weight of the dependent 
portions below their level. The effect, then, is most 
decided upon the cervical and upper dorsal portions of 
the spinal column. The weight may be made to affect 
the lumbar portion of the spinal column mostly, by 
having the patient swing from a support to the armpits. 
In this case, the musculature, and especially the latissimus 



400 Spondylotherapy Methods. 

dorsi, will support the upper portions of the spine, and 
the strain will fall most heavily on the lumbar portions. 

The writer has witnessed the results of stretching of 
the spinal column by hanging the patient's head in a 
halter, and has learned that a perceptible difference in 
the height of a patient may be produced by merely swing 
ing with the body weight resting upon and supported 
by the musculature of the spine. 

An arrangement for this purpose may be manufactured 
at home and at small expense. The plan ordinarily used, 
is to manufacture a head halter with a rope attached, 
which runs over a pulley at the top of the room. Then 
when the halter is fitted on the head, the loose end of 
the cord may be pulled through the pulley by the patient 
himself, or by an assistant. 

As the halter lifts the patient until his feet are clear 
of the floor, the weight comes on the musculature of the 
spine, but the amount of the stretch, or the tendency to 
stretch, is most intense at the upper portion, and decreases 
in intensity as we pass to the lower portion of the spine. 

This is just the reverse of what occurs when a patient 
stands in a natural position. As the patient stands, the 
body is supported by the spinal column. The lower 
segments of the spine have more superimposed weight 
than do the upper segments. 

3. Manual Traction. — Simple manual traction is 
more frequently used as an auxiliary measure in giving 
specific thrusts to overcome spinal lesions. 

We find by a slight traction, which loosens up the 
musculature of the spine slightly, and opens slightly the 
vertebral articulations, we can more easily adjust a 
spinal articulation by a specific thrust, than when no 
traction is made. Manual traction is almost exclusively 
made as an auxiliary measure in making adjustments in 
the cervical region and in the upper thoracic regions. 
Some of the most effective and specific adjustments are 



Spondylotherapy Methods. 401 

made in the cervical, and also in the upper thoracic 
regions when we apply manual traction. 

Manual traction is also used in the adjustment of 
children, and it is an excellent auxiliary in giving adjust- 
ments in all regions of the spine of a child. 

Specific directions for making manual traction in 
connection with adjustment of the cervical and upper 
thoracic regions, will be considered in a subsequent 
chapter, in which we take up the subject of Methods of 
Spinal Adjustment. 

4. Bimanual Thrusts. — The bimanual thrust is one 
that is given with one hand, while the other hand is so 
placed as to produce a traction upon the spinal column. 
This is usually accomplished by having the pelvis of the 
patient over a roll. One hand, then, will be placed upon 
the sacrum, and the other upon the spinous process of 
the vertebra to which the thrust is desired to be given. 

A thrust given in this way in some cases works very 
nicely, and is an expedient and convenient way of giving 
a thrust, and at the same time exerting a slight traction 
as an auxiliary measure for loosening up the articulations 
that may be impinging the nerve sheath. 

5. Vibrato Traction. — Simple traction accomplishes 
good. Simple traction, plus vibration, is much more 
effective. The vibration seems to produce a relaxation 
of the musculature of the spine when given in connection 
with tension, and much more than simple stretching 
alone will accomplish. We may apply vibration to the 
musculature of the spine in different ways: 

One way which is most easy and simple, and most 
frequently used, is to get a tension upon the spine, either 
by swinging the patient or by stretching the patient 
upon a table in the prone position. While the tension 
is upon the spine, we may vibrate the musculature of the 
spine, and thus assist in the relaxation. 

There is practically no expense about vibrating while 



4:02 Spondylotherapy Methods. 

the spine is under traction, for the reason that stretching 
machines are inexpensive and vibrators are comparatively 
cheap. 

The nature of the vibration should be that of massage, 
as the concussion stroke treatment is not palliative, and 
does not produce relaxation like the ordinary vibratory 
movements. 

6. Traction Adjustment. — By traction adjustment 
we refer to adjustment that is made while there is tension 
applied to the spinal column. 

This plan of adjusting, while the spine is under 
traction, is advantageous in many ways: 

1. A spinal contraction may be adjusted, and the 
articulations may be opened, and the spinal musculature 
of that segment relaxed more easily, while the spine is 
stretched, than when it is not under tension. 

2. If a spinal articulation is opened by adjustment 
under tension or traction, the adjustment will be less 
apt to be painful, and this is an important point. The 
fact that an adjustment is sometimes instantaneously and 
temporarily painful is true when the nerve which makes 
its exit from that special point of the spine is tender. 

When adjustment is made without any tension or 
traction upon the spinal tissues, the mere act of spring- 
ing the back downward in making the adjustment with 
the patient in a prone position, temporarily, but instantly 
narrows the intervertebral foramen. This for the instant 
increases the impingement upon the nerve, and excites a 
shock of pain. 

When the spine is tensed by stretching, the movement 
of the articulation, then, is of the nature of a separation 
without any narrowing of the foramen, and consequently 
without any pain whatever, because of the fact that the 
nerve is liberated, and instantly has more room and is 
freed from impingement as a result of the adjustment 
under tension. 



Spondylotherapy Methods. 403 

After considerable thought and experience, we have 
been able to produce an adjusting table that enables us 
to have the spinal column under a decided tension when 
the thrust is given; consequently relief of tender nerves, 
without producing any instantaneous shock or pain, as 
is necessarily produced by the practitioner of chiropractic 
spondylotherapy who adheres to but one idea. This 
table is simple and inexpensive, while other tables are 
much more cumbersome and inconvenient, and sell for a 
handsome price. 

7. Longitudinal Vibration. — Another and more 
effective method of vibrato- traction may be obtained by 
an end-to-end vibration, which is produced by a foot 
and head attachment enabling us to produce the spinal 
traction. This traction vibration produces a constant 
moving apart, and then toward each other, of the vertebrae 
for a fraction of an inch or so, from 500 to 1,500 times 
per minute. This causes a lengthening and relaxation of 
the spinal ligaments very rapidly, and produces a decided 
relaxation of the musculature of the spine and an increase 
in the height of the patient. 

This treatment has also a decided stimulating effect 
upon the circulation and upon the tonicity of the spinal 
musculature. This is no doubt the most effective way of 
overcoming the settling of the spine that takes place as 
age comes on, and a most stimulating method of treat- 
ment that will entirely overcome that tired or exhausted 
condition after a hard day's work. 

The subject of spinal stretching has received much 
attention and is worthy of much more attention and 
more constant use by the busy practitioner of rational 
methods of treatment. 

MECHANICAL STRETCHING 

Writer's Note. — Although stretching has long been recognized as a part of 
the indicated treatment of curvatures of the spine, dislocations, and kindred 
deformities, it is only within the last few years that its wide and general 



Spondylo therapy Methods. 405 

therapeutic value has received scientific credence. Likewise all devices 
for scientifically applying the principle, are of recent invention. Scientific 
stretching by mechanical means as now widely employed, is essentially a 
part of the new education in healing, which includes the sciences of chiropractic, 
osteopathy, mechano-therapy, etc. In the discussion which follows, its use 
as an assistant to practitioners of all schools is suggested, with the ex- 
pectation, however, that its most direct appeal will be to the chiropractors. 
Should this discussion chance to recite some of the philosophy expressed 
elsewhere in this book, it is because we find that repetition emphasizes 
the importance of the ideas to be covered. 

In the promotion of disease, the derivative influences 
of pathologically implicated spinal muscles and ligaments 
are manifold. That through injury or other causes they 
become hyper- and hypo-toned, i. e., their tonicity is 
changed, is common knowledge. Abnormal contractures 
mean a shortening of a muscle or ligament. Hypo- 
relaxation of any part of the musculature is generally 
traceable to overcontracture in another part. 

As the muscles and ligaments shorten, the segments 
of the vertebrae are drawn together in too close relation. 
If the shortening take equal force on all sides of the 
column, the spine is said to settle. If the tension is 
greater on one side than on another, the equilibrium of 
the column is at once disturbed; the vertebras become 
unplumb. If the malalignment be slight, we call it a 
subluxation; if it be great, a curvature. While it is 
often asserted that in a settled spine the relation of the 
vertebrae to each other need not be altered, yet this is 
not true. There should be no doubt but that the slightest 
settling of the spine tends to change the normal curves 
of the body. 

As the contractured muscles and ligaments draw upon 
the spinal column, the vertebral bodies are made to com- 
press the nbro-cartilages, whose function it is to maintain 
a perfect alignment of the column, give elasticity and 
mobility to it, to act as shock absorbers for the nervous 
system, and which determine the size, shape and con- 
dition of the spinal apertures which are the exits of the 
nerves and blood vessels as they pass from the spinal 



406 Spondylotherapy Methods. 

cord, with nourishment for the muscles and organs of 
the body. The intervertebral cartilages make up about 
five inches of the column's length, and their importance 
in the body is out of all proportion to the attention they 
have received in the literature of the sciences. Having 
no nerves, no blood vessels, and no lymphatics, they 
depend for their nourishment upon their ability to absorb 
and transform, into solid substance, the constant exuda- 
tions of lymph from the contiguous vessels. 

To draw these fluids into the joints of the column 
where they are consumed by the cartilages, a vacuum-like 
action in the joint is necessary. In the normal spine, 
where the freedom of the movements of the joint is not 
interfered with, the natural movements of the body — the 
bending forward, backward and sidewise, which our daily 
activities and exercises call forth, with its alternate 
stretching and relaxing of the surrounding tissue, produces 
the required vacuum-like action, and the lymph necessary 
for the constant rebuilding of the cartilages is readily 
drawn into its little canals (canaliculi) and there trans- 
formed. 

As the vertebrae are brought, by contraction of the 
connective tissue, abnormally close together, they com- 
press these cartilages. The cartilages flatten and the 
canaliculi are rendered unreceptive to the absorption of 
the fluids as a sponge under pressure would be to water. 
The lymph is not taken up by them and we thus get a 
primary cause of the depletion and destruction of cartilage 
and its train of derivative evils. Cartilages starve for 
lack of nourishment as does a muscle or organ of the 
body whose nerve and blood supply is diminished. More- 
over these exudations of lymph remain unused in the 
surrounding tissues; they stagnate and poison and 
contribute to many other pathological conditions. 

With the flattening of these cartilages, also comes a 
diminution in size, and change in shape, of the spinal 



Spondylotherapy Methods. 407 

apertures. The relation of the processes to each other 
is changed ; the current of nerve force and flow of blood 
from the cord is obstructed ; the organs fed by the nerves 
exiting from the involved joint or joints suffer starvation, 
and we have disease. Cut off the current entirely, and 
we have paralysis somewhere. We may get, in a com- 
paratively young person, a condition of "old age," 
through the general settling of the spine as a result of 
hypertonicity in the muscles and ligaments. The bones, 
skin, blood vessels, and muscles all suffer when nerve 
nourishment is obstructed. 

These contractured muscles retard the circulation of 
blood and lymph. Perfect metabolism and muscular 
efficiency require that a given amount of these fluids 
circulate in a given time. 

The spinal muscles receive their vascular branches 
from the same arteries that supply the spinal cord. If 
circulation within the muscles themselves is retarded the 
blood supply to the cord is supernormal and congestion 
is the result, a healthy circulation in the cord being 
prerequisite to healthy circulation elsewhere in the body. 

Manifestly any attempts to permanently cure any of 
the diseases which result from nerve and blood obstruc- 
tion, starvation, etc., must consider the primary causes 
and remove them, before lasting benefits follow. 

While no doubt can be expressed, that immediate 
benefits follow the setting up of "spontaneity" by means 
of the "thrust," or other hand adjustment upon the 
involved nerves at their point of exit, yet cartilage 
regeneration and a restoration of the muscular and liga- 
mentous tonicity are paramount. 

Contractures can be most speedily and effectively 
overcome and a normal tonicity established, by placing 
the patient upon a flat, and as near hard, surface, as is 
possible without discomfort. Under these conditions 
voluntary relaxation is best encouraged. For general 



408 Spondylotherapy Methods. 

traction, which can be universally employed not only 
with safety, but with good results, the body should be 
engaged at the head (occiput and chin, leaving the fore- 
head free), at the axillae, in most instances, and at the 
ankles. Where localized stretching is indicated or 
desired, other engagements can be made. No muscular 
effort on the part of the patient should be called for in 
securing the stretch. The traction should be applied 
steadily and maintained until a complete relaxation of 
the musculature is secured. Patients soon discover the 
soporific effects of the stretch and the futility of resist- 
ance. They can be depended upon to aid, by voluntarily 
"letting go." The resiliency of the body is very apt to 
surpass the expectations of even the physician, unless he 
has experimented widely. 

In a stretch covering several minutes it is constantly 
necessary to take up the "slack" of the body, following 
the muscular relaxation and cartilaginous expansion. 
The amount of traction required, or desirable, cannot be 
measured by any means whatsoever, save by the attitude 
and feeling of the patient. Attachments for gauging in 
pounds the amount of the stretch, and the habit of pre- 
scribing a given amount in any given case, have been 
discarded by all intelligent experimenters. No two cases 
present the same muscular development, or the same 
education in relaxation, and no individual case will 
present the same needs on two consecutive occasions. 
The individual feelings in each case, at the time of stretch- 
ing, is the best gauge, and the only scientific prescription 
is — give all the patients will take without exceeding their 
resiliency, which will be evidenced by a twitching sensa- 
tion in the muscles, a feeling of involuntary resistance. 
This sensation many times serves as an indicator for the 
length of time the stretch should be continued, as well. 

During seven years of wide use, by hundreds of 
practitioners, no discouraging effects have resulted, and 



Spondylotherapy Methods. 409 

my personal belief, supported by the opinions of many 
eminent physicians of the various schools, is, that the 
more generally stretching is employed in the treatment 
of both acute and chronic conditions, particularly those 
of structural origin, the greater will be the success of the 
practitioner. So much greater tension is required than 
seems credible to the unacquainted, that we feel justified 
in discouraging attempts at hand traction, and the use 
of suspension apparatuses which depend upon the weight 
of the body to provide the stretch. 

If it is to be either scientific or effective it must be 
maintained for several minutes and applied over a wide 
area. If applied alike to tensed and relaxed muscles 
simultaneously, the shortened muscles and ligaments 
protect the hypo-relaxed or normally toned ones, so that 
they will be subjected to only sufficient stretch to increase 
their cellular activity in a way to promote normal develop- 
ment. The fear which is sometimes expressed, of over- 
stretching relaxed muscles, is thus seen to be entirely 
groundless. The shortened muscles and ligaments must 
take the burden of the stretch before the normal ones 
are reached. 

The body should be so supported mechanically, at 
the dorsal curve, that it would be in a scientifically correct 
standing posture were the machine "upended;" then there 
is no tendency to reduce the normal curves of the body. 
The patient is stretched until the cartilages are freed 
from osseous pressure caused by contractures. These 
cartilages readily expand under proper influences and, as 
they do, the vertebrae are forced into normal relation 
vertically. The spinal apertures are opened, nerves and 
vessels are freed and we have the food materials at hand 
for the repair of diseased conditions. Drainage within 
the muscles is facilitated, waste products and poisonous 
lymph are forced out, their activity is accelerated, and 
they are picked up and carried out in the circulatory 



410 Spondylotherapy Methods. 

channels. The stagnated venous blood too long retained 
in the tissues surrounding the cord is eliminated and its 
devitalizing effects overcome. 

Traction squeezes the lymph and blood from the 
capillaries and tissue in the muscle fibers and new tissue 
is built up. The cartilages freed from compression are 
rendered receptive to the fluid exudations intended for 
their nourishment and their regeneration proceeds. While 
the patient is retained in this state of fixed traction, the 
chiropractic thrust can be given for specific correction 
and an added effectiveness attaches to the spontaneity 
set up in the joints, under these conditions. The hand of 
the practitioner is relieved of the necessity of combating 
the resistance of tensed muscles where the stretching 
preliminary is employed and the vertebrae will be found 
infinitely more receptive to the thrust. From this it is 
reasonable to argue that the correction is more accurate, 
minutely scientific, and less haphazard. 

The therapeutic value of retaining the body in this 
state of fixed traction for a time after hand correction has 
been made, is obvious. The activity which is set up by 
the thrust, where the muscles and ligaments have not 
been brought into a proper state of receptiveness, is 
diminished and its recuperative and reparative value 
modified. The steady, vigorous drawing of the muscles 
and ligaments on all sides of the column, or of a sub- 
luxated vertebra, until they are brought out of the 
contractured condition, through relaxation and again 
into an artificially tensed state, is a most potent assistant 
in establishing definite normal alignment. Some exag- 
gerated subluxations which have resisted, successfully, 
over a period of years, the efforts at hand correction of 
some of the ablest practitioners, have "snapped" into 
alignment when placed under the first strenuous mechani- 
cal stretch, and a permanent correction has unquestion- 
ably been made in several cases, in an instant. 



Spondylotherapy Methods. 411 

The steady stretch upon both ends of a curved spine, 
drawing it into a normally straight line, while at the 
same time retracing the course through which the case 
has traveled in creating the curvature, overcoming the 
conditions which contributed to it, is, we believe, the 
most direct means of correcting curvatures and kindred 
deformities. 

That stretching is a most promising and potent 
assistant in locomotor ataxia and paralysis is now quite 
freely admitted, and the claims made for it have been 
verified in several instances. The belief is that the 
benefits arising, are due to an increase of activity in the 
good cells and the consequent derivative influence on the 
morbid ones. 

It is agreed among many of the foremost authorities, 
that in either the first, second or third stages of locomotor 
ataxia, seldom, if ever, are all the cells included in the 
degeneracy, that the sensibility of many of them respond 
to proper influences. The hope is that through the 
establishment of functional activity of the nerve cells 
and trunks, the co-ordinative powers may be restored. 

That the cord itself can be stretched and actually 
extended, cannot be doubted, and the result of this 
stretching is, we believe, the same as it would be in a 
muscle. Muscular contraction and relaxation is necessary 
for the nutrition of the muscle. There is every reason to 
believe that the stretching of the cord, the nerve filaments 
and trunks, aids in the removal of lymph and with it 
the waste products through the promotion of a free 
circulation, while at the same time the processes of 
oxidation and repair are enlivened. If we can, as seems 
certain, increase the activity of the cells in one portion 
of the cord, the belief that it will have a beneficial deriva- 
tive influence upon the degenerating cells in other portions 
is well grounded. The action is similar to massage or 



412 Spondylotherapy Methods. 

vibration, though penetrating deeper with a consequent 
greater effect upon the nerve centers. 

The same relaxing and contracting effects in the 
muscular walls can be secured through stretching, as 
through exercise of other forms, at the same time the 
increased circulation is distributed over so wide an area 
of the body and under such conditions of freedom as to 
relieve the heart of the customary labors following other 
forms of exercise. 

The most we can hope to do in the space of a single 
chapter is to suggest uses for stretching. We have 
endeavored here to point out a few specific uses such 
as will cause the practitioner to put his mind onto the 
idea, knowing that needs for such assistive agents will 
suggest themselves in numbers. 

By David Bertram Cropp. Formerly of the Faculty of the University 
of Colorado and Dakota University. Inventor of the Stretcher, the Trac- 
tion Couch, and other Devices for Mechanically Stretching the Body. 

The illustration on page 413 shows the patient lying face upward 
upon the stretcher, engaged at the head, shoulders, and ankles. The body at 
the dorsal curve is supported on spring crutches connected by a wide leather 
strap. This support serves the double purpose of holding the body of the 
patient in a correct posture, prohibiting too great stretch against the curve 
of the body at that point, and forces the shoulder blades in in such manner 
as to stretch the intercostal muscles and cartilages, elevating the chest walls, 
enlarging their dimensions so that greater freedom for the vital organs is 
established. 



Spondylotherapy Methods. 



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CHAPTER II. 
MASSEURING. 

MASSAGE has been extensively used for many, 
many years. It is a popular method of treatment, 
and there is no doubt that masseurs accomplish 
much good; otherwise people would not support the 
profession. 

Massage has a positive and decided action upon the 
physical condition and the functional activity of the 
peripheral and accessible portions of the body, and 
reflexly, a decided influence upon the internal physical 
and functional conditions. 

Some writers enumerate a few of the principal effects 
of massage in the following manner: 

1. Increases the secretions. 

2. Lessens visceral congestion. 

3. Stimulates automatic reflexes. 

4. Lightens the work of the heart. 

5. Assists the peripheral circulation. 

6. Causes breaking up of adhesions of joints. 

7. Produces exudation and stimulates absorption. 

1. Increases the Secretions. — Massage increases 
the secretions of all the glandular organs of the body. 
Those glandular tissues that are situated in accessible 
regions so that they may be influenced by massage, are 
stimulated mechanically, and also by influence upon the 
nervous system, by stimulating the peripheral afferent 
nerve endings. 

The deep glands that cannot be mechanically stimu- 
lated because of their inaccessibility, are stimulated 
reflexly through the influence of massage upon the 
peripheral system. 

2. Lessens Visceral Congestion. — Massage, by 

414 



Masseuring. 415 

determining the blood to the peripheral portions of the 
body, relieves the internal congestion of the viscera of 
the trunk. Massage, either active or passive, by means of 
special exercises, is very helpful and conducive to health 
by relieving visceral congestion and stagnation, and by 
promoting a flow of the blood to the peripheral muscles 
and extremities. 

3. Stimulates Automatic Reflexes. — The terminal 
afferent filaments of the nervous system, and especially 
the gray rami of the sympathetic system, are stimulated 
by peripheral manipulation, as massage; consequently 
reflex response is stimulated, and all of the automatic 
action of the nervous system is increased, and a general 
tonic effect is produced. 

4. Lightens the Work of the Heart. — Massage 
increases the circulation of the periphery of the body, 
and in this way causes an equalization of the circulation 
throughout the entire body, and this greatly lessens the 
work done by the heart, inasmuch as the heart's work is 
to maintain an equalization of the central and peripheral 
circulation. 

We find an evidence of this fact in fasts. When a 
patient is fasting, there is no internal or visceral conges- 
tion produced by the process of digestion; consequently 
the work of the heart is greatly diminished or reduced to 
the minimum. 

On the other hand, many people, with weak hearts, 
have died of heart failure shortly after eating a hearty 
meal. Internal congestion produced by the effort of the 
internal viscera to take care of the food stuff, has thrown 
too much strain upon the heart, which was laboring to 
maintain an equalization of the circulation at the time 
of death. 

5. Assists the Peripheral Circulation. — Active or 
passive action of the muscles causes much more blood to 



416 Spondylotherapy Methods. 

be determined into them and mechanically aids the move- 
ments of the contents of the vascular system. 

Active exercise causes an increase in the amount of 
blood in the peripheral muscular tissues of the body. 

Massage which produces passive exercise of the 
muscles, will determine an excessive amount of blood into 
the peripheral muscular tissues of the body or the parts 
that are manipulated. 

6. Cause of Breaking Up of Adhesions. — The liga- 
ments and tendons of joints, because of deposits within 
them, and the consequent irritation, seem bound by 
innumerable minor adhesions, preventing free move- 
ments of the joints, and, in fact, all movement without 
pain. 

Massage helps in exudation and absorption, and 
increases the circulation and tends to break up the 
adhesions slowly, and for this reason it is a very helpful 
procedure on parts or joints of this nature. If, however, 
there is an infection and a process of germ development, 
then the massage may cause an absorption of the toxins 
produced by the germs. 

Sometimes constitutional symptoms are in this way 
produced, the principal of which is elevation of tem- 
perature. An elevation of temperature following massage 
is because pathognomonic germ toxins are generated in 
the tissues of the joint, which are absorbed into the 
general circulation and which stimulate the action of the 
thermogenetic nerve centers. 

7. Promotes Exudation and Stimulates Absorp- 
tion. — Massage increases all glandular activity, as stated 
above, whether the glands are accessible to the mechanical 
influence of massage, or whether they are affected by 
the reflex stimulation through the sympathetic nervous 
system. All glandular exudation and absorption is 
thereby increased, also the exudation of the muscular 
tissues, because of the mechanical stimulation produced 



Masseur in g. 417 

by manipulation, will be increased, and the absorption 
of the necessary nutrient elements, and even of patho- 
logical exudates, will be generally increased for the same 
reason. 

In the above remarks we have referred principally 
to a general massage, but the more important effects of 
massage are produced by manipulations along the spinal 
column. 

Dowse observes that "ten minutes' massage of the 
spine will increase the volume of the pulse and the tem- 
perature, generally, more than one hour's work at the 
body as a whole, the spine being omitted." 

In massage of the spinal musculature, we stimulate 
the nerves at their spinal origin, and have a decided action 
upon their peripheral functional activity. In massage of 
the spinal column, we are working directly upon the 
nerves that ramify all portions of the body at their 
spinal origin. Because of this concentration of our 
manipulation at the origin of the nerve supply, we are 
enabled to affect all parts of the body by manipulating 
a small portion thereof, viz., the spinal column. 

Marion Edward Clark, D. O., observes in his excellent 
work on Applied Anatomy: "It does little if any good to 
treat the effects — that is, to try to relax or contract the 
muscles by direct manipulation of them, unless there is 
a structural shortening, since their condition is the effect. 
Adjust the vertebra, and the effect will disappear." 

Direct manipulation of the musculature of the spine 
is no doubt conducive to a relaxation thereof, and thereby 
in a measure, in a mild way, relieves contraction and 
interference with the nerve supply. In other words, it 
relieves the cause, that the effect may disappear. 

We will say, however, in this connection, that massage 
is a very slow and ineffectual way of relieving contrac- 
tions of the musculature of the spinal column, compared 
with the specific thrust to stretch and relax the muscula- 



418 Spondylotherapy Methods. 

ture of any contractured portion, thereby relieving the 
nerve. 

We enumerate some of the different methods of 
procedure that we embrace under the art of masseuring, 
as follows: 

1. Flexing. 

2. Tapping. 

3. Swaying. 

4. Friction. 

5. Stroking. 

6. Kneading. 

7. Springing. 

1 . Flexing. — We can do flexing of the spine by having 
the patient sit in a chair with one of the operator's hands 
on the back of head and the other against the chest. In 
this way we can flex the upper portion of the thoracic 
region. Now, again, the patient may sit on the floor, 
the legs extended straight and bent forward, while the 
operator produces a pressure on the back of the head 
which will flex the entire spine and stretch the sciatic 
nerves. 

2. Tapping. — Tapping may be done with the end of 
the fingers, with the palm of the hand, or with the ulnar 
border of the hands. The tapping is more stimulating 
to the deeper tissues and to the nerves than is friction. 

3. Swaying. — Swaying of the spine may be done by 
using a table especially prepared for such work. The 
way we have our up-to-date adjusting table built, the 
spine may be swayed from side to side, thus loosening 
up some of the non-used ligaments and tendons of the 
spine, which sometimes is very helpful in case of the 
deposit of uric acid or urates in the slightly used muscles 
or tissues of the spine. This is a very great assistance 
to us in gaining that flexibility and suppleness of the 
spine that is so necessary to the circulation and healthful 
condition thereof. 



Masseuring. 419 

Swaying may be done by the patient sitting on a 
stool, and supporting the head on the arm, while a lateral 
movement or pressure in the thoracic region or even in 
the lumbar region, which is made with one hand of the 
doctor, while his other hand holds the supporting arm 
of the patient's head. Swaying may also be accom- 
plished while the patient lies prone on the operating 
table, by catching the opposite lower limb about the 
knee with one hand, and pulling it toward the side on 
which the operator stands, while the pisiform bone of 
the other hand presses against the spinous processes of 
the lumbar vertebrae, pushing them from the operator. 
This movement may be applied to either side, and to 
any spinous processes from the first to the fifth lumbar, 
and this will greatly assist in relaxing the lateral ligaments 
of the lumbar region. 

4. Friction. — Friction is sometimes used to stimu- 
late the skin action and capillary circulation. It is 
sometimes used on the point of irritation, in which case 
it may act as a counter-irritant. It is sometimes used 
immediately after a thrust is given to nullify the painful 
temporary effects or muscular spasm caused by the 
thrust. 

5. Stroking. — Stroking is a palliative method that 
is used simply to allay an excitable condition of the 
peripheral endings of the afferent nerves in the superficial 
tissues of the spine and to stimulate the internal abdominal 
viscera by external stroking upon the abdominal surface. 

6. Kneading. — Kneading is used to a considerable 
extent by some practitioners who work upon the spine. 
Deep kneading is very effective sometimes in stimulating 
the circulation and relaxing contracted ligaments along 
the spinal column, and is very palliative and sometimes 
effective in doing great good. 

7. Springing. — We find springing of the spine, like 
swaying, helps to produce flexibility of the spinal column. 



420 Spondylotherapy Methods. 

The patient should lie upon the chest, being also sup- 
ported in the pelvic region, while the back is being 
sprung down at different parts or segments until we 
produce the flexibility that is so very much desired. 

III. Concussion. — Concussion is a very important 
method of procedure in spondylo therapeutic methods. 

We may relieve all interference with the nerve sheath 
by relaxing any of the musculature of the spinal column 
which is contractured, and any narrowing of the foramen 
through which it passes from the neural canal by spinal 
adjustment. We may, by removing interference with 
the nerve sheath, open the conducting paths of all nerve 
impulses, and remove all occlusion of the vascular system, 
and thus restore normal nutrition and normal drainage. 
We may, in this way, restore the normal impulse of the 
nerve supply. 

There is no doubt that when we remove interference 
with the nerve supply, that the very act of removing the 
pressure from the nerve will stimulate and excite an 
increased action. This, however, is temporary in effect, 
and in time we cease to have anything above the normal 
functional activity of the nerve supply from these 
sources. 

By concussion we can do more, provided the con- 
cussion is done in connection with measures that over- 
come interference with the nerve supply. Concussion of 
the spine will stimulate the roots of origin of the motor 
efferent nerves. 

Concussion may be applied continuously for several 
minutes, and decided stimulation of the motor efferent 
nerves may be produced and continued. There are 
cases in which we want more than the normal nerve 
supply to restore a normal condition, owing to the ex- 
tent of the pathological lesions. 

$£ The conditions may be such that the normal impulse 
is not sufficient to restore the normal condition. In such 






Masseuring. 421 

cases, an increase, or an excessive nerve impulse or nerve 
activity, may accomplish what the normal nerve action 
will not accomplish; hence concussion, used as an 
auxiliary method, is an important agency, stimulating 
the nerve action, and thus becomes a very important 
means of restoring the normal conditions in tissues 
supplied. 

Spinal nerves are responsible for all the function in 
all the tissues of the body. They exert an influence 
upon the glandular secretions, upon the metabolic pro- 
cesses, upon thermogenesis, and also control thermic 
regulation. They control the motor influences of the 
muscular tissues, and vasomotor influences over the 
vessels of the circulation. 

The vasomotor influences control vasoconstriction 
and vasodilation of the blood vessels. When we stimu- 
late the spinal centers, we may intensify the phenomena 
described above. As indicated, we may, by relieving the 
nerve of all interference, obtain the normal impulse and 
normal functional activity; we may be able to enhance 
the impulses beyond the normal, but concussion is a 
wonderful aid to still further stimulate and increase the 
different phenomena of nerve function. 

It is necessary that we understand the centers which 
control the vasoconstriction and vasodilation, and also 
the condition of the muscular tone of the different viscera 
of the body, before giving treatment. 

Concussion, without sufficient knowledge, may be 
very detrimental. For example: We may produce vaso- 
dilation when we should produce vasoconstriction, and 
vice versa. In case of hemorrhage of the lungs we would 
produce vasoconstriction in order to check the hemor- 
rhage. Now if we were not familiar with the different 
spinal reflexes, we might, by stimulation of the vaso- 
constrictor and also the vasodilator centers, produce no 
perceptible effect. The excitation produced in such 



422 Spondylotherapy Methods. 

cases would nullify each other. We might even stimu- 
late the vasodilator, when we wish to stimulate the 
vasoconstrictor action. In this case, we would have 
exactly the reverse effect to what we desire to produce. 
We had a patient come to us two weeks since and he 
was having a continuous but light hemorrhage from the 
lungs continuing for nearly three weeks. We, by using 
the concussion stroke vibrator over the fourth and fifth 
cervical vertebrae, entirely stopped the spitting of blood. 
After two weeks, while writing this, the patient returned 
greatly improved from the two treatments we gave him. 

In the case of aortic or abdominal aneurism or dilata- 
tion of the heart, we should have a thorough knowledge 
of the vasoconstrictor centers if we would excite a vaso- 
constrictor influence upon these organs. We should 
never stimulate the vasodilator centers for the reason 
that we would nullify the beneficial effects of stimulation 
of the vasoconstrictor centers. Or, in case we did not 
stimulate the vasoconstrictor centers, then by a stimu- 
lation of the vasodilator centers we would produce a 
very unfavorable result. 

Dr. Albert Abrams, of San Francisco, Cal., has fur- 
nished some very valuable information as to the location 
of the spinal reflexes, and we are pleased to acknowledge 
full credit to him for a great deal of the information that 
we have been able to acquire concerning this subject. 
From personal experience we want to heartily endorse 
what he has laid down, and we have thoroughly tested 
this matter in our clinical work during the last year or 
two. We have been able to accomplish some very 
wonderful results by a combination of the chiropractic 
spondylotherapy method and by concussion of the spinal 
column over relative spinal centers. 

By adjustment, we are enabled to open up the channels 
for the transmission of nerve impulse. By concussion we 
are able to increase these impulses, and for these reasons 



Masseuring. 423 

we feel that we have had a much greater success by a 
combination of the two methods of spondylo therapy, 
than we could have had by either alone. This matter 
will be taken up and considered again in the Methods 
of Adjustment in subsequent chapters. 

IV. Sismotherapy. — Sismotherapy, or vibrato-ther- 
apy, is a method of treatment that is used on different 
parts of the body, but in spondylotherapy it is used 
almost exclusively in the treatment of the musculature 
of the spinal column. 

This method of treatment is a very excellent auxiliary 
to other methods of spinal treatment. The effects 
obtained by use of the vibrator depend, to a great extent, 
upon the nature of the stroke of the vibrator that is used. 
If the lateral or rotary movement is applied to the spine, 
or to either side thereof, we will have produced thereby 
a mechanical massage. This mechanical massage may 
only affect the peripheral tissues, but by pressure, the 
deeper tissues may be influenced. 

This vibratory massage movement stimulates the 
circulation of the blood and lymphatics, and has a 
tendency to relax muscles and tendons; in fact, many 
of the results of manual massage may be equaled, or 
perhaps exceeded by mechanical massage produced by 
the use of the vibrator. It is quite effective, often, in 
the relief of pain. 

In the case of aged people with contractured conditions 
of the musculature of the spinal column, the vibrator is 
good, and an effective way of relieving that contracted 
condition. It is a palliative treatment that is preparatory 
to a favorable condition of adjustment, and, on the other 
hand, it is a treatment that will prevent soreness which 
follows spinal adjustment. 

The vibrator is also useful as a means of promoting 
the absorption of the by-products of digestion, such as 



424 Spondylotherapy Methods. 

uric acid, etc., and, like massage, it may be used to advan- 
tage in these conditions. 

In sismo therapy we may use a vibrator that has a 
direct straight concussion stroke instead of a massage or 
lateral or rotary movement. The concussion stroke is 
decidedly more effective as mechanical stimuli to the 
nerves and spinal centers, and we get an entirely different 
action from stimulating the spinal nerves at their exit, 
or at the origin of their roots in the spinal column, by 
vibration or concussion, than we do by adjustment. By 
the vibrator we get a mechanical stimulation of the 
centers, depending upon the length, force, and rapidity 
of the stroke. It is estimated that at least three strokes 
par second are necessary to excite any stimulation of 
any consequence, and that ten strokes per second will 
excite almost or quite the maximum stimulation. In 
fact, more rapidity of the rate of vibration than ten 
strokes par minute does not produce proportionately 
greater excitation. 

It is well to remember that concussion and stimulation 
of certain spinal centers will produce vasoconstrictor 
action upon the vessels and viscera of the trunk, while 
concussion or hammer stroke upon other segments of the 
spine will produce vasodilator effects upon the vessels 
and viscera. 

Now if all the centers of the spine are stimulated 
alike, we have a confusion of results. The effect of the 
stimulation of one center will counteract the effects of 
the stimulation of the center that will produce the opposite 
effect, 'hence, it is necessary to understand the spinal 
centers and their specific influence as to motor, vaso- 
dilator and vasoconstrictor influence upon the vascular 
system, and the viscera of the trunk before presuming to 
give concussion stimulation to the spine. 

We have fortunately been able to find a vibrator that 
gives the concussion stroke and it has proven very 



Masseuring. 425 

effective. We have used a mallet made of rubber, as a 
plexor, and a pleximeter of rubber. By manual concussion 
in this way, we have produced some very satisfactory 
results. 

We have been able to strengthen the heart beat, and 
inhibit the rate thereof, and we believe that the vibrator 
that we use that gives the pure simple concussion stroke 
of sufficient length, strength and rapidity, is a much 
more practical instrument in the hand of the well-educated 
than any ordinary vibrator, and is much more effective 
than manual concussion. 

We have experienced difficulty in securing an outfit 
for our concussion stimulation of spinal centers, as it is 
difficult to secure an outfit that would do the work 
satisfactorily, and that would not be too expensive. We 
are glad that we have been able to find a satisfactory 
outfit run by electric current and at a very reasonable 
price. After months of use with this outfit we are satisfied 
with it in everv way. 



CHAPTER III. 
THERMOTHERAPY. 

THERMOTHERAPY, like sismotherapy, may be 
used to produce local effects on any part of the 
body. 

Thermo therapy consists of the application of heat. 
The action of a hot application in spinal treatment is 
confined almost exclusively to the spinal column, but 
thermotherapy may be used as a peripheral application 
to affect the local circulation, and also to influence the 
reflex action of any portion of the body. 

The effect of a hot application is stimulating, the 
duration of the continuation of the stimulation depend- 
ing upon the intensity of the heat. A mild application 
of heat exerts a stimulating effect continuously, while a 
sufficiently hot stimulant may soon destroy the sensi- 
bility and the histological condition of the part to which 
the heat is applied. 

Hot applications determine blood to the local zone to 
which they are applied, and thereby produce a hypersemic 
condition. They also hasten the circulation of the blood 
and increase the flow in the lymphatic channels. 

When a hot application is made to any portion of 
the spine for the purpose of stimulation, the above con- 
ditions of stimulation and hyperemia are induced in the 
spinal segment, in that portion of the spine that is 
stimulated by the hot applications. 

Hot applications will often relieve pain and uneasiness 
if the application is properly regulated, as to the tem- 
perature, and the number and length of the time of the 
application. 

The application of heat has primarily a decided 
stimulating effect, and the first differs materially from the 

426 



T her mother apy. 427 

secondary effect, in vasomotor influence and action. The 
primary effect of a hot application produces vasodilation 
in the local zone to which the heat is applied, and conse- 
quently there is a reddened or hyperaemic condition. A 
long continued application of heat will produce a chronic 
contraction of the vascular channels of the zone to which 
it is applied, and will, for this reason, produce a pale, 
white, and anaemic appearance because of the induced 
anaemic condition. 

We may wish to produce and to maintain the primary 
effect without inducing the secondary. We may wish to 
produce a hyperaemic condition of a certain segment of 
the spinal column, and to continue that effect for some 
time without inducing the secondary and anaemic effect. 

In order to prevent the secondary vasoconstrictor 
effect of the hot applications, we find it necessary to 
alternate from the hot to the cold applications frequently. 
The primary effect of the heat will last from about three 
to five minutes, when the secondary effect begins to ensue. 

If we alternate and apply a cold application at the 
conclusion of about four minutes of the application of 
heat, we will for the time reverse the conditions induced 
by the heat, and will induce a rush of blood supply in 
response to the vasoexciting influences of the cold appli- 
cation. This will enhance the effects of the hot applica- 
tion in the way of determining the liquid elements to the 
local zone. 

When the heat is again applied, again we have vaso- 
stimulating effects produced, and another increase of the 
hyperaemic condition of the part. The cold application 
should be applied only about one minute. This altera- 
tion of the temperature of the application, not only 
maintains a hyperaemic condition, but the effects of the 
application of the heat will be greatly enhanced because 
of the changes from one extreme of temperature to 



428 Spondylotherapy Methods. 

another, and the consequent increased excitation or 
stimulation. 

Heat applied to a warm surface will not stimulate as 
much as heat applied to a cold surface, and if the surface 
is made cold by an application, then the heat will produce 
a much more decided effect. So it is always well to 
observe the rules outlined below in the application of 
heat to produce a hypersemic condition, namely: Apply 
the hot application for four minutes, and then the cold 
application from one half to one minute. A repetition 
of from about four to six applications of heat of about 
four minutes each and this followed each time by cold 
application for one half to one minute, is usually sufficient 
to relieve ordinary pains, and when applied to the spine 
to produce decided therapeutic effects. 

A practical way of using thermotherapy is to do so 
by using flannel cloths about the size of one fourth of an 
ordinary single bed blanket. One piece should be folded 
and dipped in boiling water, the ends being kept dry, 
then, by twisting, the water can be wrung from it fairly 
well. The other piece of blanket should be placed over 
the zone to which the heat is to be applied. The blanket 
wrung from the hot water should then be placed over the 
dry one, and the ends of the dry blanket used to inclose 
and maintain the heat of the hot blanket. A very high 
temperature can be applied in this way. There will be 
enough dampness in the way of steam to make the heat 
moist, and this is far superior to heat from a light, as is 
often used in spinal treatment. 

Ice may be used as a convenient method of applying 
the cold alternating applications after the extremes of 
heat. The ice is not at all disagreeable after a hot appli- 
cation; in fact, patients often claim that the sensation is 
pleasant. 

Another method of applying thermotherapy is by the 
use of the thermophore. This is a pad that may be made 



Thermotherapy. 429 

any desirable size, that is placed over the local zone, while 
the end of the cord is attached to the electric socket. This 
is very convenient for the application of heat to a local 
zone. It is also very convenient to apply the cold at 
intervals, which may be done by simply raising the hot 
pad and passing the ice underneath it. 

After the local zone is chilled for a minute or half a 
minute, the pad may be replaced to the part. The 
exchanging of the hot and cold applications in this way 
is a very convenient matter. 

Still another method of thermotherapy is practiced 
by means of therapeutic lamps. Heat is applied to any 
zone in this way. Heat may be applied along the spinal 
column also. The difference in the color of the light 
applied will produce different effects upon the local zone 
to which it is applied. We may cause vasoconstriction 
or vasodilation by difference in color used, in the appli- 
cation of therapeutic rays. 

Thermotherapy directly applied to the spinal column 
will accomplish more in fifteen to twenty minutes than 
the hot applications to other portions of the body will 
accomplish in an hour. Not only are the effects much 
more readily produced, but they are much more decided 
when applied to the spinal centers than when applied 
to the peripheral portions of the body. In one case we 
stimulate the roots of origin of the nerves; while in the 
other we get the reflex influence only. 

So, for constitutional and general effects, the hot 
fomentations, the thermophore or the therapeutic light, 
will have a much more decided effect when applied 
directly to the spinal column where we may affect the 
spinal centers. 

VI. Psychrotherapy. — Psychro therapy in the prac- 
tice of spondylotberapy consists of cold applications and 
of cold freezing mixtures usually applied to and 



430 Spondylotherapy Methods. 

expected to affect the spinal nerves at, or near, their 
spinal exit. 

The object of the application of the cold is for the 
relief of pain, which is produced as a result of the con- 
tinuation of the application of cold. Applications of 
cold are also applied to other parts of the body for the 
purpose of producing reflex influences, but in spinal 
treatment the application of cold is confined more 
directly to segments of the spinal column and usually 
for alternating effects. 

The primary effect of the cold application is stimula- 
tion, unless we should have a failure of reaction against 
the application. The stimulation is proportionate to the 
amount of reaction against the application of the cold. 

Placing the hands in cold water will cause an imme- 
diate reaction, a congested condition, and an increased 
local thermogenesis will immediately ensue. This is 
well known to the laity, who are accustomed to dashing 
their hands in cold water to relieve them of a frost- 
bitten condition. 

The stimulating effects of cold applications are not 
so transient as might be supposed. A cold application 
increases heat production. 

General applications to the body increase the tonicity 
and thermogenesis of the entire body. The cold sponge 
bath is an excellent preventive against general colds, 
which may be produced by the changes of the weather, 
provided the skin is inactive and weak in power of 
reaction. 

The farmer who runs around the house in his bare 
feet in the snow in the morning and then dries the snow 
from his feet and puts on his shoes, will ordinarily have 
feet comfortably warm the whole day long. 

The skin's activity is practically what we educate it 
to be, and there are agencies that will stimulate reaction 
against the changes of the weather, such as the brief 



T her mother apy. 431 

applications of cold, hence the skin should be educated 
to react against the sudden changes in weather by brief 
exposures to cold applications. 

It is the exciting effects of the application of cold that 
makes it useful in spondylotherapy. If the cold is needed 
as a sedative application, it should not be applied con- 
tinually for a long time. A long continuation of the 
application of cold will temporarily paralyze the zone or 
part to which it is applied. 

We may, however, continue the application of cold, 
or even ice, for a considerable time if We will take the 
pains to alternate the cold applications with hot appli- 
cations. For example, if we apply the cold four minutes 
then we may apply the hot one minute. The hot applica- 
tion not only overcomes the temporary condition pro- 
duced by the cold application, but prevents complete 
paralysis, as would ordinarily be produced by the con- 
tinued application of cold, and this will also greatly 
enhance the beneficial effects of the cold application. 
This is due to the fact that one reaction after another 
against the application of the cold may be brought on 
by repeated changes from the hot to the cold applications. 

One question that may arise, is: Which is best to 
apply to a patient, the hot or the cold application? This 
question, the feeling of the patient will answer. Always 
make the application that relieves or is most palliative 
to the patient's feeling. As a rule, a close adherence to 
this principle will always guide us aright. 

Heat, like cold, applied to the spine, produces a 
decided excitation and stimulation of the spinal centers. 
The application of cold has also been employed for the 
relief of pain by the continued application of freezing 
mixtures, or by the application of ice to the origin of the 
spinal nerves. Sometimes clear distilled water has been 
injected into the tissues, and then by means of a freezing 
mixture, has been converted into ice, which allays the 



432 Spondylotherapy Methods. 

pain and deadens the sensibilities, and produces a paralysis 
of the nerve which is affected by this freezing for the 
relief of pain. 

We do not feel that this is a wise plan to pursue. 
Pain is simply the interpretation of an impulse conducted 
usually by a live and often healthful nerve. We should 
not paralyze that nerve which tells the story, but rather 
relieve the mechanical interference and obstruction that 
interferes with the integrity of that nerve, causing the 
pain. This can be done in practically all cases almost 
immediately by spinal adjustment. 

A cold application to the back of the neck will produce 
a vasoconstrictor influence of the vessels in the region of 
the cranial nerves. This measure has been taken advan- 
tage of often by the laity, who have learned that by 
placing a cold pack to the back of the neck, they may 
control nose bleeding. 

The cold pack is also frequently used for the relief 
of inflammatory conditions in rheumatic joints. In this 
case, the application is usually made around the joint 
itself, instead of being applied to the spine to excite 
nerve centers. The most common use that we make 
of the cold application in spondylotherapy, is the use of 
it as an alternating application when we are applying hot 
applications to the spine. 

Nerve Pressure. — Nerve pressure may be applied 
to any part of a nerve in its course, but in spondylotherapy 
it is usually applied to nerves near their spinal origin 
from the neural canal of the spinal column or along their 
track of distribution, if that track is accessible. 

Nerve pressure will allay the irritation, and also 
relieve the tenderness of a nerve, and often by this method 
pain is readily relieved. 

We find often that after tracing a tender nerve, and 
having palpated it from the spine perhaps to a peripheral 
zone, that the pain will entirely disappear, and thus it 



T her mother apy . 433 

would appear, that from mere pressure upon the nerve, 
while palpating, that the tenderness and pain are entirely 
relieved, and for this reason we are led to believe that 
this would be an important auxiliary method of spinal 
treatment. 

Such an auxiliary method would be especially useful 
in the treatment of a patient with a very tender condition 
of the spine. In some patients in which there is consider- 
able contracture of the musculature of the spine, an 
adjustment is almost an impossibility, and where the 
nerve is very tender, an instantaneous shock of pain 
will be produced by the thrust, and also soreness will be 
produced because of injury to the nbrillse of the spinal 
tissues. 

Milder methods, such as swaying, massage, nerve- 
pressure, and vibration, may, in such cases, be employed 
to good advantage. Not only is it more agreeable to 
the patient, but more conducive to good in many cases. 
These remedies, while they are reducing the spine to 
a normal condition, and removing the tenderness so we 
can really adjust, will also allay an irritable condition 
of the nerve and improve its function. 

We certainly feel it a mistake on the part of many 
who practice spinal adjustment, that they are not broad 
enough in their ideas. They see but one way of doing 
anything for a patient, and will fail to be successful for 
that reason in many cases, especially old persons. There 
are others more considerate of the needs and conditions 
of their patients, and they are also more resourceful and 
handle their patients more successfully and reach cases 
that others fail to satisfy. 

We have had some very successful experience in the 
administration of nerve pressure as an auxiliary method 
of treatment on several occasions, and for this reason 
we feel anxious to urge this matter upon all practitioners 
using spondylotherapy methods. 



434 Spondylotherapy Methods. 

A patient called at the writer's office suffering with 
tic douloureux. He complained that he had suffered 
almost constantly for three weeks. He held his hands 
cupped, and declared he had taken as much as the two 
hands full of medicine, but had received no relief, except 
a temporary effect from the use of anodynes. 

We made a careful examination, feeling sure that the 
cause of the tic douloureux, which was toward the outer 
side of the right orbital region, was the result of some in- 
terference with the upper cervical nerves. We located a 
nerve emerging from the spine, and found it to be ex- 
tremely tender when palpated. We traced this nerve 
from the cervical region segment step by step to the zone 
of the pain. This nerve seemed to be somewhat less 
tender the further we traced it, and by the time we 
reached the location of the pain, the patient declared he 
had no pain whatever. It was either pressure upon the 
nerve or imagination that cured his pain. 

We took the precaution, however, to relieve the con- 
traction in the neck that was causing interference with 
the nerve, to prevent any return of the pain. The tic 
douloureux disappeared and did not return. Not only 
was this a great victory for spinal adjustment, but it 
signified quite emphatically the importance of palpating 
nerves, and the application of pressure upon them for 
relief of pain. 

One other very important case, and example of nerve 
pressure as an auxiliary method in spinal treatment, was 
the case of a little girl who was taken ill very suddenly 
with spinal meningitis. The writer was called to the 
child soon after the attack, and found the spinal column 
exceedingly tender. Not thinking of meningitis, we 
decided that it was owing to some injury to the spine 
sustained while playing with children. A mild treatment 
was given; some hot applications were recommended 



T her mother apy . 435 

to be applied to the spine, and we judged that the child 
would soon recover. 

The next day we had a hurried call to go to the child, 
who lived six miles distant. When we arrived, we found 
the child apparently breathing its last. The parents and 
friends were grouped around the bedside, and the child 
lay with head drawn back; the child had a very 
high fever with an occasional tremor running over its 
body apparently as if breathing its last at each respira- 
tion. We confidently believed the child would not have 
lived even ten minutes without relief. 

We began by nerve pressure between the transverse 
processes to those regions of the spine which seemed to 
be most involved ; in fact, we applied some nerve pressure 
to all portions of the spinal column from the upper 
cervical to the lower lumbar, inclusive. In twenty 
minutes' time the child was decidedly relieved, and was 
regaining consciousness. In less than an hour, we left 
the bedside of the child, but it had recovered sufficiently 
to be conscious and to ask questions, and to assure the 
friends and parents that it was not suffering with any 
pain whatever. It seemed wholly relieved. The child 
also soon asked for nourishment. An assistant was sent 
who worked with the child some more that afternoon. 
The treatment was kept up for three days, when the 
case was dismissed as being out of danger. 

During the entire treatment not one single spinal 
adjustment was given. Nerve pressure was depended 
upon, together with some hot and cold applications. The 
recovery was rapid, and no sequelae ensued, and we con- 
sidered the case remarkable and a great victory for 
rational spondylotherapy methods. 

In conclusion, we might enumerate the office equip- 
ment necessary in the practice of spondylotherapy 
methods, as outlined above: 



436 Spondylotherapy Methods. 

1. Thermophore. 

2. Portable table. 

3. Stretching table. 

4. Adjustment table. 

5. Urinalysis outfit. 

6. Electric vibrator. 

7. Percussion apparatus. 

The urinalysis outfit mentioned above is especially 
to be recommended because of its diagnostic importance. 
We have been able to relieve albuminuria, glycosuria, and 
diabetes mellitus in a number of cases. 

When such work is accomplished by spondylotherapy 
methods, it is hard to make a disbelieving people believe 
it. We want all the positive evidence at our command to 
be brought to bear in all such cases. 

A careful urinalysis will first give us a correct idea of 
the abnormal function of the kidneys. A subsequent 
urinalysis, giving negative results, will give positive 
evidence of the efficacy of our treatment, and such 
evidence as will convince the most skeptical. We should 
also send specimens of the urine to some known and 
reliable laboratory and the laboratory analysis will 
corroborate our work. 



CHAPTER IV. 
ATLAS METHODS. 

ADJUSTMENT of the spine means, literally, to 
procure therein a normal condition, and freedom 
from all interference with the spinal nerve supply 
which may result from spinal lesions. 

If lesions are produced as a result of contraction of 
the musculature of the spine, then adjustment means 
simply a relaxation of the spinal ligaments, thereby 
overcoming the contraction. 

Any undue approximation of vertebra is due, usually, 
to contraction of the musculature of the spine, or to a 
settling of the spine, and a consequent thinning of the 
intervertebral cartilages. If we relax the spinal ligaments 
and separate the articular surfaces which have been 
approximated, then there is a tendency on the part of 
the intervertebral cartilaginous discs to expand and 
overcome the thinned condition into which they have 
been forced by long-continued compression. 

When the writer at first made a study of the subject 
of adjustment, it was under teachers whose idea of sub- 
luxation was that a vertebra had slipped out of its place 
from some cause and that an adjustment was for the 
purpose of pushing it back to where it belonged. We 
were further taught that a vertebra would perhaps 
remain as we adjusted it for an hour or so after being 
thrust into its normal position. After continued adjust- 
ment, the vertebra, it was claimed, would remain in 
place longer each time, until finally the vertebra would 
permanently stay where it belonged. 

We were further taught that a person turning in bed 
was liable to slip a vertebra out of its place. We were 
also taught that this slipping of a vertebra out of place 

437 



438 Spondylo therapy Methods. 

would not occur all at one time, but would occur partially 
each time a person turned over, until it remained entirely 
and permanently out of place. 

Then, according to this, the adjustment is the act of 
thrusting a vertebra back to where it belongs until a 
repetition of this procedure, from day to day, causes 
the vertebra to remain where it belonged. 

At the present we are glad to feel that we have 
advanced far ahead of the teaching we received along 
this line from our first preceptors in spinal adjustment. 
The idea of a vertebra slipping out of place will never 
appeal to thinking and intelligent people. Such a theory 
as we were taught, would never be believed nor taught 
by a man of thorough education and competent under- 
standing of anatomy. 

The real fact, as believed by educated men who have 
made a study of this subject, is, that it is a settling of 
the spine or a contraction of its musculature, that approxi- 
mate vertebrae narrow the intervertebral foramina, and 
cause nerve interference, as outlined in a previous chapter 
on the causes of spinal lesions. 

We have also made considerable advancement in 
gaining a knowledge of better methods of relieving spinal 
lesions or conditions which are called subluxation of the 
spinal column or vertebrae. It is only after investigating 
and. determining for ourselves the above information 
concerning the cause and relief of spinal lesions, that we 
are enabled to fully appreciate the true philosophy and 
importance of the science of chiropractic spondylo- 
therapy. 

We were not long in finding that the methods of 
adjustment which were first taught us, were as crude 
as were the theories we were taught. By travel, by 
study, and by visiting with others, we have succeeded 
in learning many better ways of loosening up the con- 



Atlas Methods. 439 

traded musculature of the spinal column and overcoming 
interference with the spinal nerves. 

Many American practitioners of chiropractic and 
osteopathic spondylotherapy have succeeded in develop- 
ing many improved methods of adjustment. We have 
been successful in learning a little and picking up a method 
of adjustment here and there, and have made efforts to 
obtain all the possible information we could that we might 
raise the standard and efficiency of spinal adjustment. 

We have made a study of the methods used in Bohe- 
mia, the country from which some crude methods of 
adjustment were first introduced into this country. 
We find that the Bohemians in their native country, 
who are now better posted in the practice of spinal 
adjustment, use many excellent methods of adjustment 
that their countrymen, uneducated in this line, did 
not introduce into this country, probably from the lack 
of competent knowledge concerning this matter. The 
American practitioners have added some excellent manip- 
ulations which are very useful methods of spinal adjust- 
ment. 

We have spared neither time nor expense in obtaining 
all the information we know to be possible, and since so 
doing, we are giving you in this volume many new and 
better American methods of adjustment as well as the 
many excellent methods of the Bohemians, which so far 
are unknown except to a few on the American continent. 

At the present time Ave are giving in the neighborhood 
of fifty-five methods of spinal adjustment, whereas 
when we first began the work of chiropractic spondylo- 
therapy we had been taught but three methods of adjust- 
ment, we have found by experience that there was much 
room for advancement from the limited knowledge of 
this science possessed by our first teacher. 

In our study of the methods of spinal adjustment, we 
find it cotrvenient to study the peculiar methods especially 



440 Spondylotherapy Methods. 

effective in each of the different segments of the spine. 
We divide the spine into the following divisions: 
I. Atlas methods. 
II. Cervical methods. 

III. Upper thoracic methods. 

IV. General thoracic methods. 

V. The general lumbar methods. 
VI. Special fifth lumbar methods. 
VII. General spinal adjustment methods. 

I. Atlas Methods. — We now use and teach eleven 
methods of atlas adjustment. We will enumerate these 
methods of adjustment under the following heads: 

1. Old method. 

2. Bimanual method. 

3. Transverse method. 

4. Finger pivot method. 

5. Knuckle thrust method. 

6. Bimanual thrust method. 

7. Mento-occipital thrust method. 

8. Mento-occipital rotary method sitting. 

9. Mento-occipital rotary method pronate. 
10. Mento-occipital rotary method dorsal. 

II. The transverse anterior thrust method. 

1. The Old Method. (See Illustration, page 441.) — 
This is a method of adjustment of a patient's atlas while 
he is lying prone upon the adjustment table. 

The method of procedure in giving this adjustment 
may be described as follows: 

Position. — The patient should lie prone upon the 
adjustment table. Face may be turned to either side. 

First. The face of the patient is turned towards the 
operator, adjuster standing on the patient's left side. 

The ulnar border or pisiform bone of the left hand 
is placed upon the lamina of the posterior arch and 
transverse process of the atlas, hugging close to the 
occipital bone. 



Atlas Methods. 



441 




Atlas adjustment (old method) . 



442 Spondylotherapy Methods. 

The fingers are extended round the back portion of 
the neck. 

The right hand supports and strengthens the left. 

The thrust is given at an angle of about 45 degrees 
downward and from the operator. This thrust opens 
the occipito-atlantal articulation on the opposite side. 

By reversing the head or direction of the face and by 
changing the hands so as to use the ulnar border of the 
right hand on the side of the posterior arch of the atlas, 
the opposite side of the occipito-atlantal articulation 
may be opened. This method is quite uncomfortable, 
unpleasant, and while effective in some cases there are 
other methods that are more effectual and much less 
disagreeable and less uncomfortable to the patient, and 
for this reason we seldom use this method since learning 
so many better ones. 

2. Bimanual Method. Atlas Method. (See Illustra- 
tion, page 443.) — The contact of the bimanual with ulnar 
border of the hand on transverse process. This method is 
practically painless and a very easy method in which a 
person may easily become proficient. 

Position. — Have patient lie on adjustment table in 
the prone position while the operator stands at the head. 

Support the head on one hand while the other hand 
is used to give the thrust. Apply the ulnar border or 
pisiform behind the transverse process of the atlas. 

If the atlas is to be adjusted and the articulation 
opened on the left side, then place the ulnar border of the 
right hand in contact with the transverse process of the 
atlas while the head is rotated, the chin of the patient 
toward his left shoulder and supported by the left hand. 

Give thrust against transverse with the right hand 
and thrust the head upward with the left hand and make 
the thrust with each hand simultaneously and have the 
direction of the movement of the two hands in directly 
opposite directions. This will easily move the atlas or 



Atlas Methods. 



443 




Bimanual atlas method. 



444 Spondylotherapy Methods. 

open the articulation on the opposite side to which the 
thrust is given. To op an up the articulation on the opposite 
or right side, rotate patient's chin to the right and the 
occiput to the left shoulder. Rest the patient's left 
cheek upon your right hand and thrust with the left 
hand on the transverse process of the atlas upon the left 
side. 

The same contact and movement may be used in 
making an adjustment of the axis, third or fourth cervical 
vertebra. 

A simple test for the purpose of determining if the 
occipito-atlantal articulation is normal, is to have the 
patient look directly overhead. The patient should 
stand with the feet placed flat upon the floor, while the 
neck is flexed back so as to look directly overhead. If 
there is no interference with this movement in any way, 
then the atlas articulates properly with the occipital 
bone, and there can be no subluxation of it unless there 
be a uniform contraction and approximation of the atlas 
on both sides with the occipital bone, then the movement 
will not be normally free, but limited. 

3. Transverse Method. (See Illustration, page 
445.) — This is a very simple and easy method, and in 
this way an adjustment or an opening up of the occipito- 
atlantal articulation may be very easily accomplished. 

The technique of the method may be described as 
follows: 

Position. — The patient sits on a" chair or stool while 
the operator stands behind. ., 

When we desire to open the occipito-atlantal articu- 
lation upon the right side, stand behind the right shoulder 
of the patient. 

Extend the right hand around the neck of the patient 
on the right side until the contact finger reaches the 
transverse process of the atlas upon the left side. 

Place the fingers of the right hand behind the trans- 



Atlas Methods. 



445 




Transverse atlas method. 



446 Spondylotherapy Methods. 

verse processes of the atlas on the left side of the neck 
close against the occipital bone. 

Place your left hand against the right side of the 
patient's head. 

Flex the head over the finger that is holding the 
transverse process of the atlas. 

When the head is flexed as far as possible, and when 
there is no further resistance, a thrust is given to the 
transverse process of the atlas which will loosen up the 
articulation on the right side when the pressure is made, 
as it is in this case, upon the transverse process of the 
left side of the atlas. 

When the finger is pressed against the atlas, and when 
the head is flexed as far as it will, we may sometimes 
obtain a complete relaxation by a slight movement of 
the head, before giving the thrust. 

The thrust is given almost wholly with the finger that 
is pressed against the transverse process of the atlas, 
while the other hand is used to maintain the flexion and 
to steady the head, but no thrust should be given with 
the supporting hand against the side of the head. 

If we wish to loosen up the occipito-atlantal articula- 
tion on the left side, then the operator should stand 
behind the left shoulder of the patient. 

Extend the left hand around the neck in front and 
catch the transverse process of the atlas on the right 
side of the neck with the middle or index finger. 

Use the right hand against the left side of the head to 
support it and flex it over the middle linger of the left 
hand which is supporting the right transverse process of 
the atlas. 

When complete flexion and relaxation is obtained, 
the thrust may be given with the middle finger of the 
left hand to the right transverse process of the atlas, in 
this way the left side of the occipito-atlantal articulation 
may be loosened. This is an excellent method of atlas 



Atlas Methods. 



447 




Finger pivot atlas method 



448 Spondylotherapy Methods. 

adjustment and may be also used upon the other cervical 
vertebrae in making adjustment. 

4. Finger Pivot Method. (See Illustration, page 
447.) — This is a very effective method of loosening up 
the occipito-atlantal articulation, and it is a method 
that we frequently use in our work of spinal adjustment. 

Position. — The patient should lie upon his back 
upon the adjustment table, while the operator stands at 
the head of the patient. 

The face of the patient may be turned to the right 
or to the left and the fingers of the corresponding hand 
of the operator used as the pivot. 

If the face is turned to the right, then the tips of the 
middle and ring fingers of the right hand are placed 
against the lamina of the atlas upon the right and inferior 
side. 

These fingers should be flexed at right angles with 
the hand, while the back of the hand rests upon the 
table. In this way we get a solid support and conse- 
quently a permanent pivot for the atlas and head. 

The contact of the supporting fingers to the lamina 
of the atlas should be as near the posterior border of the 
neck, or to the posterior portion of the arch of the atlas, 
as possible. 

The left hand then is placed upon the chin of the 
patient. 

The head should then be rotated, the chin to the 
right, at the same time the lamina of the atlas should 
be supported by the fingers of the right hand underneath. 

When the rotation is as far as the head will move 
then a slight movement following a slight relaxation 
will open the occipito-atlantal articulation on the opposite 
side to the support given to the lamina of the atlas; 
this is done very easily and effectively The landmark 
for finding the laminae of the atlas is the point about 



Atlas Methods. 449 

half way between the inferior prominence of the mastoid 
cells and the spinous process of the axis. 

This method is a very excellent one, and far superior 
to the methods described above, and for this reason we 
consider it one of our best methods of atlas adjustment. 

5. Knuckle Thrust Method. — This is a thrust 
applied to the front of the transverse processes of the 
atlas, and may be given by folding the fingers and by 
placing the knuckles in the inner space between the 
inferior maxillary bone and the transverse process of the 
atlas upon either side of the neck. 

A thrust is then given with the knuckles of the bent 
finger to the front of the transverse processes as the 
patient lies upon the back; this movement tends to 
correct a forward condition of the atlas. A better contact 
in giving this adjustment is to place the pisiform bone 
against the transverse process of the atlas. 

This is not a very practical method of adjustment, 
for the reason that the knuckles or point of contact 
will too often press upon the nerves, and the thrust will 
be painful. The pressure of the folded fingers cannot 
be gotten directly in contact with the front of the trans- 
verse process of the atlas without using considerable 
caution. This method, however, is quite effective in 
some subluxations in which a transverse process of the 
atlas is anterior, when it is desired to thrust it backward 
into its proper position. The pisiform portion of the 
ulnar border of the hand may be used instead of the 
knuckles, and this is a better contact and consequently 
a better way to make this adjustment. 

6. Bimanual Thrust Method. (See Illustration, 
page 450.) — This is an easy method that may in some 
cases be used advantageously. 

Position. — The patient lies prone upon the adjust- 
ment table, while the adjuster stands to one side. 

Head may be turned on either side of the face, first, 



450 



Spondylotherapy Methods. 



and then rotated to the other direction for adjustment 
on the other side of the atlas. 

One hand catches the occiput of the patient's head 
while the other hand is in contact with the side of the 
face that is up. 

A sudden thrust is then given to the occiput and side 
of face simultaneously, that thrusts the head away from 
its close articulation with the atlas. 

This is one of the most easily executed and most 
accurate adjustments that can be made — with the patient 



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Atlas Methods. 451 

lying either upon the back, or prone upon the face. This 
adjustment is especially to be recommended, because, if 
properly given, there is practically no pain felt by the 
patient; also, this adjustment has this advantage: You 
may, by applying the greatest force to the occipital bone, 
throw the head forward and loosen the posterior part of 
the occipito-atlantal articulation, as is often necessary 
in case of approximation of the posterior arch of the atlas 
to the occipital bone. You can, by applying the most 
force to the side of the face, elevate the forward part of 
the cranium, thus separating the anterior arch of the 
atlas from the occipital bone. 

^ 7. Mento-occipito Thrust Method. — This method 
of atlas adjustment is simple, effective and painless. 

Position. — The patient lies in a prone position with 
the face turned to one or the other side. The operator, 
standing at the side of the patient, catches the occiput 
with one hand and with the other hand catches the 
patient's chin. 

The head is pushed from the body, producing a 
tension upon the patient's neck. 

A thrusting of the head away from the cervical 
vertebrae will loosen up the occipito-atlantal articulation 
upon the same side to which the pressure is applied. 

This method is useful because of the fact that it is 
painless; it also has one more advantage, which is as 
follows: When giving the thrust with the two hands, 
the most of the force of it may be applied to either the 
chin or to the occiput, as may be desired, and in this way 
we may effect either a backward or forward movement of 
the atlas. 

By reversing the head, turning the face in the opposite 
direction, the thrust may be applied to the other side of 
the head and thus loosen up the other side of the occipito- 
atlantal. 



452 Spondylotherapy Methods. 




Mento-occipital rotary method (sitting) 



Atlas Methods. 453 

8. Mento-occipital Rotary Method. Sitting 
Posture. (See Illustration, page 452.) — This is a very 
convenient method of adjustment, as it may be used 
anywhere and at any time for the reason that it is a 
convenient method of procedure in any position. 

Position. — The patient may sit on a chair or a stool 
or on the floor, while the operator stands behind. 

With one hand, catch the occiput, while the other 
hand catches the chin. 

Standing behind the patient's right shoulder the left 
hand supports the occiput, while the left hand catches 
the chin. 

The head is then raised both back and front, pro- 
ducing a gentle traction or tension upon the cervical 
musculature which will loosen up the vertebral articula- 
tions of the cervical region to a certain extent. 

The head is then rotated, the chin to the right, the 
occiput to the left, as far as it will rotate conveniently. 

At the limit of the rotation, after first relaxing partially, 
a quick movement will open up the articulation between 
the atlas and occipital bone upon one side with .com- 
parative ease. 

By reversing the above procedure, using the left 
hand to catch the chin, with the left arm upon the left 
side of the patient's neck while the right hand supports 
the occipital bone, the head may be rotated in the oppo- 
site direction and the occipito-atlantal articulation may 
be loosened up on the opposite side. 

This is a fairly good and convenient method, and 
may be used anywhere effectively, and in a general way 
is preferable to the old or beefy method. 

Practically the same principle is used in the following 
positions which we describe, the principal difference 
being changes in the technique in the changed positions. 

9. Mento-occipital Rotary Pronate Position. 
(See Illustration, page 454.) — This is a very effective and 



454 Spoyidylotherapy Methods. 




V 

Mento-occipital rotary (pronate) . 



Atlas Methods. 455 

easy way of loosening- up the occipito-atlantal articulation 
while the patient lies upon the face. 

Position. — The patient lies prone upon the table, 
while the operator stands at the head. 

One hand is used to catch the chin, while the other 
supports the occiput, but in a reverse manner to what 
is used in the mento-occipital adjustment in the sitting, 
or upright position. 

We will suppose that the patient lies with the head 
turned so as to rest the right side of the face upon the 
table. 

Then we would catch the chin of the patient with 
the right hand, and the occiput with the left, and we 
rotate the occiput toward the right shoulder of the patient, 
and the chin toward the left. 

Extension should be made at the same time we make 
the rotation. If the extension is of proper amount, and 
the rotation is sufficient, the adjustment is made with 
comparative ease. 

When the head is rotated as far as it will, conveniently, 
a slight relaxation should be made, and then a quick 
movement with comparatively little force will loosen up 
the articulation between the atlas and occiput. 

By reversing the face of the patient to the opposite 
side, and by changing hands and reversing the rotation, 
we are enabled to loosen up the articulation of the 
opposite side. 

10. Mento-occipital Rotary (Dorsal Position). 
(See Illustration, page 456.) — This is made similar to the 
finger pivot method, but varies in the fact that the hand 
under the head and supporting it does not rest upon the 
table. 

Position. — The patient lies upon the back of the 
adjustment table, while the operator stands at the head. 

One hand is caught under the chin and the other 
under the occiput, and the head is pulled toward the 



456 Spondylotherapy Methods. 




Mento-occipital rotary (dorsal position) 



Atlas Methods. 457 

operator, extending- the neck, and in this condition the 
rotation and the movement will effectually and easily 
loosen up the occipito-atlantal articulations. 

If the right hand holds the chin of the patient and 
extends on the right side of the face, and the left hand 
holds the occiput, then the chin should be rotated toward 
the left shoulder of the patient. 

If the opposite side also needs loosening up, then the 
hands should be changed. 

Extend the left hand on the left side of the face 
and catch the chin, and with the right hand catch the 
occiput, and then by rotating the chin to the right, we 
may easily accomplish the desired adjustment. 

This method is a fairly convenient way, and is some- 
times used after adjusting the lower cervical vertebrae 
by means of the Ely method of adjustment, as the 
patient already lies in the right position for this method. 

11. Transverse Anterior Thrust Method. (See 
Illustration, page 458). — This may be used in case of an 
anterior subluxation of the transverse process of the 
atlas and axis. It is not a favorable method because 
of the difficulty of obtaining a proper contact without 
infringing upon the integrity of cervical nerves and 
causing pain and discomfort. 

The patient lies upon his back upon the adjustment 
table, the operator stands at the head of the patient. 

To illustrate, we will suppose that the left transverse 
process of the atlas is anterior. 

Have the patient turn the head and lie upon the right 
side of the face. 

This rotation of the head brings the left transverse 
process of the atlas to the upper side of the head and 
neck and directly into the field of operation. 

The pisiform bone of the operator's right hand is then 
placed in contact with the transverse process of the atlas. 



458 



Spondylotherapy Methods. 



Be careful in obtaining a contact that is not painful 
to the patient. 

The direction of the thrust should be backward and 
downward. This is a method that is seldom used. 




Transverse anterior thrust method. 



CHAPTER V. 
CERVICAL METHODS. 

WE will, in this chapter, consider a number of 
methods of procedure that have been and are 
used, in loosening up the articulations between 
the cervical vertebrae. Many different methods have 
been used, and each and every one of the methods seem 
to possess some advantages in certain cases owing to 
the many different circumstances under which adjust- 
ment may be given. We will describe several methods 
which we enumerate as follows, and which we feel to be 
efficient : 

1. The old method. 

2. The T. M. method. 

3. The rotary method. 

4. The flexed finger method. 

5. The centrum thrust method. 

6. The bimanual thrust method, 

7. The transverse process method. 

8. The transverse process rotary method. 

9. The spinous and transverse process method. 

In the above enumeration the names do not clearly 
indicate the nature of the method, but in the following 
discussion we hope to make the different methods clear 
and comprehensive. 

1. The Old Method. (See Illustration, page 441.) — 
By the old method we refer to the first method that was 
used in America and the first method learned and used 
by the writer, but we are confident that this method was 
originated in this country, being a cruder method than was 
used by the Bohemians trained in spinal adjustment. 
The use of this method in America is due to the fact 
that the persons introducing the methods of spinal 

459 



460 Spondylotherapy Methods. 

adjustment in this country, had but a vague idea of the 
methods used in Bohemia, and other places where better 
methods had been evolved. The method consists of the 
following technique: 

The patient lies upon the table in a prone position. 

The operator standing on the left side of the patient, 
should have the patient's face turned toward him. 

Apply the ulnar border or pisiform bone to the side 
of the neck to the processes of the vertebrae. 

The force of the thrust is directed against both the 
transverse and spinous processes of the vertebras. 

The thrust is given downward, and the direction is 
slightly backward at an angle of something like 45 degrees 
down and from the operator. 

In order to loosen up the articulations of the cervical 
vertebrae on the opposite side, the face is turned to the 
other side. The operator may stand on the same side, 
or step to the other side. 

The right hand is used by placing the ulnar border 
or pisiform bone in contact with the processes of the 
cervical vertebrae. 

The left hand is used to reinforce, and the thrust is 
given to this side the same as to the other side. 

Ordinarily, in adjusting in this manner, one thrust is 
given to the top of the neck, affecting the atlas or axis. 

A second thrust is given to the center of the cervical 
region, affecting the third, fourth, and fifth cervical 
vertebrae. A third thrust is given to the lower portion 
of the cervical region to the sixth and seventh cervical 
vertebrae. This is repeated on the other side in the 
same manner to loosen up the articulations of the opposite 
side to which the thrusts are given. 

This method, in a crude way, loosens up the articula- 
tions of the cervical region, but there is nothing specific 
about it, and it is very uncomfortable, and probably the 



Cervical Methods. 



461 




T M. cervical method. 



462 Spondylotherapy Methods. 

most painful way of giving adjustments in the cervical 
region. 

We used this method almost exclusively for a long 
time, until we found that the instruction we had received 
in this science was very inefficient, and until we learned 
that there were many better methods that were and 
might and should be used in preference. 

2. The T. M. Method. (See Illustration, page 461.)- 
By T. M. method is meant the thumb movement method, 
but when we consider the technique of the movement, 
the name falls short of expressing its nature. 

The movement is given while the patient sits erect 
on a chair or a stool of ordinary height. 

The operator stands behind the patient. 

The thumb is placed firmly against the spinous pro- 
cess of the cervical vertebra which is to be supported. 

The other hand is placed in contact with the opposite 
side of the head, and the head is flexed over the contact 
thumb. 

While the patient relaxes, a side movement is given 
that will loosen up the articulation between the vertebra 
which has its spinous process supported, and the adjacent 
vertebra above. 

This method should be given with great caution to 
prevent straining of the ligaments, causing soreness and 
contractions that may cause trouble. 

First, the head should be flexed as far as possible, 
and the thrust should be given lightly when at about the 
limit of the normal flexion. 

If the head is moved too far, when making the thrust, 
and in this way gains too much momentum, before it 
comes to the limit of normal flexion, the force of momen- 
tum may be of such an extent as to strain or injure the 
ligaments attaching the vertebrae. Should there be too 
much strain, then trouble may be produced. For the 



Cervical Methods. 



463 




Rotary method. 



464 Spondylotherapy Methods. 

above reason, many who practice spinal adjustment do 
not use the T. M. movement. 

Probably the vertebrae which may be best adjusted 
by the T. M. method, are the sixth and seventh cervical 
and first thoracic. 

This method may also be used in adjustment of the 
first and second thoracic vertebrae. We sometimes can 
loosen up articulations in this region most successfully 
with the T. M. movement. 

3. The Rotary Method. (See Illustration, page 
463.) — This method we first learned of, and it is used 
almost exclusively in connection with our school work in 
Oklahoma City and by those trained at this college. It is 
a method that produces some advantageous results under 
certain conditions, and it is an effective way of loosening 
up the articulations from the fourth cervical, down to 
and including the second thoracic vertebrae. The 
method is as follows: 

The patient remains in a sitting position on a bench 
or chair. 

The operator should stand behind the patient clutch- 
ing the chin of the patient. 

The head is dropped as far as possible with the chin 
upon the patient's chest. 

The thumb of one hand of the adjuster is placed 
against the spinous process of the vertebra that should 
remain stationary immediately below the articulation 
which is to be opened up. 

The other hand extends on the opposite side of the 
neck, and catches the chin of the patient. 

While the spinous process is supported by the thumb, 
and while the head is flexed, the chin is rotated, turning 
the occiput to the side that is supported by the thumb. 

This is a very effective way of loosening up the artic- 
ulation immediately above the vertebra which has its 
spinous process supported. 



Cervical Methods. 



465 




Flexed finger method. 



466 Spondylotherapy Methods. 

By reversing the hands, and by supporting the 
spinous process on the opposite side, and catching the 
chin and rotating it in the opposite direction, we will be 
able to open up the articulation on the opposite side of 
the neck. 

This method has an important advantage in one 
respect: When the head is flexed, the spinous processes 
of the lower cervical vertebrae are separated so that they 
may be easily distinguished and palpated, and for this 
reason we may know exactly what vertebra we are 
adjusting. 

This method also gives a good leverage to the operator, 
so the articulations may easily be loosened up. 

In the technique of the above, we might specify more 
closely, by stating that if the thumb of the left hand is 
used to support the spinous process, the thumb should 
be placed against the left side of the spinous process, 
while the right hand extends on the right side of the neck 
and catches the chin with the finger upon the left side. 

Then the chin is drawn to the right, while the occiput 
rotates to the left. 

The spinous process is forced in the opposite direction. 

In this way, we have the rotary loosening up of the 
articulation between the supported vertebra and the one 
immediately above. 

4. Flexed Finger Method. (See Illustration, page 
465.) — In using the fingers flexed in applying a thrust, 
we find some advantages: 

(a) Because of the width of the surface of contact of 
the adjuster's hand. 

(b) Because of a straddling of the prominence of the 
processes with the fingers. 

The fingers are flexed, and the middle phalangeal 
bones or portions of the finger, form the surface of 
contact. 

The upper portions of the surface of contact should 



Cervical Methods. 



467 




Centrum thrust method. 



468 Spondylotherapy Methods. 

be placed against the vertebra which it is desired to 
adjust, with relation to the one immediately above it. 

The thrust is given to the transverse and spinous 
processes. 

The operator may stand on either side of the patient 
while the patient lies in a prone position. 

The patient's face may be turned in either direction, 
while the thrust is given. 

It is an effective method, and will often open up two 
or three articulations at one time. It is a method that 
gives us some advantages, but one that we seldom use. 

5. Centrum Thrust Method. (See Illustration, page 
467.) — We may, by palpating the centrums of the cervical 
vertebrae, find an unevenness because of a forward 
protuberance of one or more of them. 

To palpate the centrums of the cervical vertebrae, it 
is best to press the fingers in front of the sterno-mastoid 
muscles into the soft tissues of the neck, when the cen- 
trums of the vertebrae may be easily palpated. 

If there is any prominence of a centrum, either 
forward or lateral, it will be easily detected. 

The best method of correcting such a lesion is to 
place the ulnar border of the hand against the prominence 
of the centrum. 

Then, when standing on the opposite side of the 
patient, with the head resting against the body, a thrust 
is given by drawing the prominent centrum toward you. 

This is practically a very painless and effective method 
of reducing such subluxations and evening up the anterior 
surfaces of the centrums of the cervical vertebrae. 

6. Bimanual Thrust Method. (See Illustration, 
page 499.) 

Position. — The patient lies in a prone position on the 
adjusting table with face lying toward one or the other 
side. The position of the operator is at the side of the 
patient's body. 



Cervical Methods. 469 

Contact. — The thumb of one hand is placed against 
the spinous process, on the side opposite to which it 
should be adjusted. 

The occiput of the patient is turned towards the side 
on which the contact with the thumb is made. 

The other hand is placed on the occiput of the patient 
thus making the spinous and occipital contact. 

Suppose we are wanting to throw the spinous process 
of the fifth, sixth, or seventh cervical vertebrae toward 
the right: 

Doctor's Position. — We may stand to the left side 
of the adjustment table and patient, or on the right side, 
or astride the patient. 

Patient preferably lies with his face to the side opposite 
the operator and with the occiput of the head toward 
the operator. 

With the thumb of the left hand we support the 
fifth, sixth, or seventh spinous process upon the left side. 

The right hand is placed upon the occiput of the 
patient. 

The slack is all taken out by a rotary movement 
rotating the occiput to the left and the spinous process 
which is supported toward the right. 

A slight thrust now in the two directions in which 
we are rotating the spinous process and the occiput will 
easily accomplish the desired adjustment. 

If the spinous process of a lower cervical vertebra is 
to the right side instead of the left, and we wish to throw 
it towards the left to bring it into normal alignment, then 
we reverse our hold. 

We use the thumb of the right hand against the right 
side of the spinous process of the vertebra to be adjusted, 
or the one just below it. 

The left hand then should be placed in contact with 
the occiput. 



470 Spondylotherapy Methods. 

The head in this case is turned to the right, while the 
face is turned toward the operator. 

Rotate sufficient to overcome all slackness and at 
the same time we support the spinous process of the 
vertebra with the thumb of the right hand; this will cause 
a loosening up of the articulation between the vertebra 
whose spinous process is supported and the one imme- 
diately above it. This is a very easy and effective way 
and much superior to that used by the ordinary practi- 
tioners or teachers of spinal adjustment. 

Instead of using the thumb against the spinous 
process of the vertebra to be adjusted, we may use the 
pisiform bone as a point of contact against the transverse 
process; in this case the point of contact is changed from 
the thumb to the pisiform bone and to the ulnar border 
of the hand. 

The pisiform bone contact may be made upon the 
transverse process in the middle and upper cervical 
regions in making adjustment. 

Position. — The patient lies on the left side of the 
head, with the face to the left and from the operator. 

The operator places the left hand with the pisiform 
bone in contact with the transverse processes of the 
cervical vertebrae. 

The operator's right hand catches the head or occiput 
and rotates sufficiently to overcome the slack and then 
by a slight thrust we may make the desired adjustment. 

7. Transverse Process Method. (See Illustration, 
page 471.) — This is a simple and easy method, and one 
that works with comparative ease. 

The operator stands behind the patient, who sits on 
a bench or chair. 

When you desire to open up the occipito-atlantal 
articulation on the right side, stand behind the right 
shoulder of the patient. 

Let the right- hand extend around the neck on the 



Cervical Method*. 



471 




Transverse process method. 



472 Spondylotherapy Methods. 

right side, catching the middle finger upon the transverse 
processes of the cervical vertebrae. 

Place the left hand against the side of the head, and 
flex the head over the finger that is against the transverse 
processes. 

When the head is flexed as far as it will, and when 
there is no resistance, a thrust to the transverse processes 
of these vertebrae will loosen up the articulation on the 
right side when the thrust is given, as it is in this case, 
upon the transverse processes on the left side of the neck. 

To loosen up the left side, stand behind the patient's 
left shoulder, extending the left hand around the neck, 
and catching the transverse processes of the eervical 
vertebrae with the middle finger. 

Use the right hand to flex the head over the middle 
finger of the left hand, and when flexion is complete, the 
thrust may be given, and in this way the other side of 
the occipito-atlantal articulation may be opened. 

8. Transverse Process. Rotary Method. (See 
Illustration, page 473.) — This method, or one very similar, 
is generally known as the Ely movement, and is one of 
our best methods of cervical adjustment. It is practi- 
cally a painless method. The technique is as follows: 

The patient lies on the back on the adjusting table, 
while the operator stands at the patient's head. 

The head is raised by the operator, who palpates the 
tips of the spinous processes of the cervical vertebrae. 
Any lateral deviation from a normal alignment is readily 
detected, as the spinous processes are separated by the 
forward flexed position of the head, and are easily dis- 
tinguished in palpating. Any lateral condition of a 
spinous process that is found, is treated as follows: 

For example, suppose we find that the spinous pro- 
cess of a vertebra is prominent on the right side. Then 
a finger of the right hand is held against the prominence 
of the spinous process. 



Cervical Methods. 



473 




Transverse process. Rotary method. 



474 Spondylotherapy Methods. 

The forefinger of the left hand is placed against the 
tip of the finger that is first placed and held against the 
spinous prominence. 

The head is rotated with the chin to the right over 
the right hand, while the forefinger of the left hand is 
brought by a circular movement in contact with the 
transverse process of the vertebra to be adjusted. 

Slight tension is made upon the neck, and a thrust 
downward and forward is given that tends to rotate the 
vertebra upon its axis. 

This rotary movement tends to throw the spinous 
process into perfect alignment. 

This procedure may be reversed, and the vertebra 
may be rotated in the opposite direction, always observ- 
ing the rule to apply the thrust to the transverse process 
on the opposite side to the prominence of the spinous 
process that is detected. 

This is one of the most scientific and most perfect 
methods of adjusting, into perfect alignment, the pro- 
cesses of the cervical vertebrae, that we have ever used 
in our work. We have obtained some wonderful results 
by this procedure, and the beauty of it is that the ver- 
tebra can be adjusted in this way practically without 
any pain or discomfort to the patient. 

9. Spinous and Transverse Process Method. (See 
Illustration, page 475.) — This method is an effective way 
of easily loosening up the cervical vertebrae in the central 
portion of the cervical region. The technique of this 
method is as follows: 

The patient lies in a prone position. upon the adjust- 
ment table, while the operator stands at the head of the 
patient. 

If the patient's face is turned to the left and rests 
upon the right cheek, the operator then catches the chin 
with the right hand. 

With the thumb and forefinger of the left hand, he 



Cervical Methods. 



475 




Spinous and transverse method. 



476 Spondylotherapy Methods. 

obtains a contact against the lower inferior side of the 
spinous and transverse processes of the vertebra below the 
one he wishes to adjust. This contact will support the ver- 
tebra, while a rotation of the head by pulling the chin 
upward by a movement of the hand which holds it, 
will loosen the articulation immediately above the ver- 
tebra which is supported. 

This is a very effective method of adjustment, and 
the adjacent articulations may be positively and decidedly 
loosened up in this way. 

The operation may be reversed by turning the face 
in the other direction, and by changing the hands. 

This method we sometimes use in loosening up the 
cervical region in case of alveolar-pyorrhea and catarrhal 
affections. This method is not so specific as the one 
described above, but is more effective, as a greater leverage 
can be obtained in most cases. 

TRANSVERSE-OCCIPITAL-BIMANUAL THRUST. 
(Cervical Method.) 

Patient prone, operator at patient's head. 

Catch transverse processes on posterior sides with 
ulnar border or pisiform contact and direct thrust for- 
ward, and catch the occiput, as in the illustration, and 
thrust in the opposite direction at the same instant 
as thrust is given with the other hand to transverse 
processes. 

This is an easy method and can be used to advantage 
in many cases. (See Illustration, page 477.) 



Cervical Methods. 



477 




Transverse occipital bimanual thrust (cervical method). 



478 



Spondylotherapy Methods. 




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CHAPTER VI. 
UPPER THORACIC METHODS. 

THE adjustment of the upper thoracic vertebrae are 
somewhat difficult, and more especially is this true 
if we undertake to loosen up the articulations of 
the spine in this region by the first crude methods which 
we were taught and such as have been used in this country, 
and are still used by the non-progressive spinal adjusters. 
The author has been much interested in obtaining 
different methods of adjustment of vertebrae in this 
region of the spine, because of the urgent necessity of 
more effective and more accurate methods of procedure. 
We are now familiar with, teach, and use near a dozen 
different methods of upper thoracic adjustment, each of 
which is especially adapted to the different conditions 
in which we find our different patients. We will describe 
each of these methods, which we enumerate as follows: 

1. T. M. method (sitting). 

2. Lateral method (dorsal). 

3. Bimanual extension (prone). 

4. Side thrust method (prone). 

5. Side thrust improved (prone). 

6. Mento-spinous method (sitting). 

7. Mento-rotary method (prone). 

8. Occipito-spinous method (sitting). 

9. Old method forward thrust (prone). 

10. Old method backward thrust (prone). 

11. The occipito-spinous thrust (prone). 

In the above nomenclature of the different methods 
of adjustment which we have used, the name does not 
clearly indicate the method of the procedure. For this 
reason and for the purpose of describing the methods, 

479 



480 Spondylolherapy Methods. 

the following description of the technique and advantages 
of the different methods enumerated above, will be 
considered. 

1. T. M. Method. (See Illustration, page 481.)— This 
is an old method of procedure, and a method that is used 
in the cervical region, and it may also be used in the 
upper thoracic region as low as the second or third tho- 
racic vertebrae. 

Position. — The patient remains in the sitting posture, 
while the operator stands at his back. 

The thumb of one hand is placed against the spinous 
process of the vertebra below the articulation which we 
desire to loosen up. The other hand is placed against 
the opposite side of the head. The head is flexed over 
the side and over the thumb in contact with the spinous 
process. 

Complete flexion and relaxation is obtained by pres- 
sure and working the head toward the side of the spinous 
support. After complete relaxation give a side thrust, 
and the articulation will be loosened between the vertebra 
that is supported and the one immediately above. 

Caution. — Always have the head of the patient 
flexed to the side, to almost the normal limit, when the 
thrust is given. 

Always be sure that the thumb against the spinous 
process is held firm so as to give a sufficient support to 
the spinous process that is held. 

It is often necessary that the opposite side of the 
articulation be loosened up also, and in such a case this 
may be done by changing the hands, using the other 
hand against the opposite side of the spinous process, 
while the other hand is applied to the other side of the 
head. The articulation is opened by a side thrust of the 
head, as described above. 

This method works best for loosening up the articula- 
tion between the sixth and seventh cervical vertebrae, 



Upper- Thoracic Methods. 481 




T. M. method. 



482 Spondylotherapy Methods. 

and between the seventh and first thoracic vertebrae, 
bnt it should be used with caution in all cases, as too 
much of a side thrust may cause injury to or irritation 
of the ligaments of the spine, and for this reason contrac- 
tion will subsequently ensue. 

2. Lateral Method. (Patient on back.) (See Illus- 
tration, page 483.) — This method of upper thoracic adjust- 
ment is one that the author first learned after some two 
weeks of occasional attempts until we became partially 
proficient in its execution. 

It is a very excellent method, because it is effective, 
and also because it is a painless method of loosening up 
the articulations of the upper thoracic vertebrae. This 
method is one that requires considerable practice that 
we may become proficient in the art of its administration. 

The technique of the operation is more complicated 
than most methods of adjustment. For this reason it 
will be hard to describe. 

Position. — The patient should lie upon the back on 
the adjusting table, while the operator stands at the head. 

A careful palpation of the upper thoracic vertebrae 
should be made, which can be done by using a finger of 
each hand on either side of the spinous processes of the 
upper thoracic vertebrae. 

The head of the patient is raised, and the extensor 
muscles of the spine become relaxed. Any lateral devia- 
tion from the proper alignment of the spinous processes 
of this region, is in this way easily detected. 

Should we find a spinous process of an upper thoracic 
vertebra to one side or to the other, then the following 
technique of adjustment may be followed: 

Place the middle finger firmly against the spinous 
process that is prominent, because of its lateral position. 

The fingers should be pressed firmly against the 
prominence of the spinous process that is lateral. 



Upper Thoracic Method*. 483 




Lateral upper thoracic method. 



484 Spondylotherapy Methods. 

The elbow of the same hand may rest against the 
knee for a support. 

The other hand of the operator catches the occiput 
of the patient, and flexes the spine as much as possible 
around the finger that supports the prominent spinous 
process. 

When the lateral rotation of the head is to the limit, 
a thrust should be given. 

The occiput should be rotated more than the front 
of the head toward the side of the supporting finger. 

The thrust should be a lateral, rotary movement 
instead of a lateral movement, and the head should be 
lowered as much as possible when the side rotary thrust 
is given. 

The finger against the spinous process should hold it 
firmly. 

This will loosen up the articulations between the 
vertebra of the spinous process which is supported, and 
the vertebra immediately above, and owing to the flexed 
condition of the neck and upper portion of the thoracic 
region, the vertebra will easily rotate to its normal posi- 
tion and is moved with ease and the adjustment is painless 
to the patient and a very accurate method of adjustment. 

If the process should be prominent on the opposite 
side, then flex the head to the opposite side, and support 
the prominence of the spinous process on the same side 
to which the head is flexed. Administer the thrust in 
the same manner as described above, and you will 
reverse the movement of the vertebra. 

It requires considerable practice to execute this 
method of adjustment effectively, but it is one of the 
most effective and absolutely painless methods of lining 
up the spinous process of any that we have seen used, 
and for this reason it is well worth the time and pains 
to acquire the art of executing this method of procedure. 



Upper Thoracic Methods. 



485 




Bimanual extension method. V 



4:86 Spondytotherapy Methods. 

3. Bimanual Extension. (Patient prone.) (See 
Illustration, page 485.) — This method of loosening up the 
upper thoracic will also apply in the middle thoracic 
region, and is a very simple method of procedure and 
requires but a brief description; it is also a method 
that is seldom used, and this is not a very effective 
method of adjustment. 

Position. — The patient lies in the prone position, 
and should be placed over a considerable roll resembling 
the shape of half of a barrel, or half barrel in shape. 
The roll should be from three to five inches in diameter. 

One hand is applied over the sacrum, while the other 
is applied to the spinous process of a vertebra in the 
upper thoracic region. 

Considerable tension, in this way, may be brought to 
bear upon the spinal column; and the thrust may be given 
simultaneously to the sacrum and to the spinous process 
of the upper thoracic vertebra. 

This will bring a tension to bear upon all portions of 
the spine, but the point of contact of the hand to the 
upper thoracic portion of the spine will open up that 
portion of the spine first. 

This is not a very practical method, for the reason 
that we have not always the convenience for placing the 
patient in a proper position for its execution, and for the 
further reason it is not very efficient. 

4. Side Thrust Method. (Patient prone.) (See 
Illustration, page 487.) — The side thrust method is quite 
an improvement over the method that the author first 
learned. This is quite an effective method of loosening 
up the upper thoracic articulations in the majority of 
cases. The technique of this method may be described 
as follows: 

Position. — The patient lies prone upon the adjusting- 
table, while the operator stands at the side to which he 
wishes to give the thrust. 



Upper Thoracic Methods. 487 




Side thrust method. 



488 Spondylotherapy Methods. 

The patient's face is turned toward the operator, 
while the thrust is given to the spinous process that is 
to be adjusted. 

A lateral position of the patient's face will tip the 
spinous processes of the vertebrae of the cervical region 
to one side, and will also rotate the vertebrae and spinous 
processes of the upper thoracic region, but to a less 
extent. 

The pisiform bone of the left hand, if the operator 
stands on the left side of the patient, should be placed 
in contact with the left side of the spinous process of 
the vertebra to be adjusted. 

The right hand reinforces the left when the thrust is 
given. 

The thrust may be applied to the lower cervical or 
to the upper thoracic spinous processes, down to and 
including the third, and they may be effectively loosened 
up in this manner. 

By reversing the face of the patient to the other side, 
the operator may stand on the same or reverse side and 
apply the pisiform bone of the right hand to the spinous 
processes of this region, and give the thrust in the opposite 
direction. 

This method is not as free from pain as the second 
method described, but it is a convenient method of 
procedure, and one that is more easily learned and 
executed and more easily made effectual. 

5. SideThrust. Improved Method. (Patient prone.) 
(See Illustration, page 489.) — Much more leverage can be 
obtained in making the side thrust adjustment, by 
having the head raised from the table so as to increase 
the flexion of the spinal column in the region where the 
adjustment is to be given. This may be done by the 
following simple contrivance: 

Position. — The operator stands as before, uses the 
hands as directed above, and gives the thrust in the 



Upper Thoracic Methods. 



489 




Side thrust method (improved). 



490 Spondylolherapy Methods. 

same way, while the patient lies in the same position, 
but places one arm under the side of the head, as follows: 

If the patient's face turns to the right side, then the 
right arm is placed under the side of the head, so that 
the patient's face is looking toward his elbow, and toward 
the side on which the operator stands. 

To obtain the opposite adjustment, it will be necessary 
for the face to turn in the opposite direction, or to the 
left side of the table, while the left arm is placed under 
the side of the head. 

The operator then stands on the left side of the table, 
and thrusts the vertebra towards the right side. 

By placing a patient in this position, you will see at 
once that you can obtain a wonderful advantage and 
leverage, that will enable you to break up the strongest 
contractions or adhesions, and even anchylosis of the 
vertebrae of this region. 

While this method is very effective, it is not a com- 
fortable method to the patient; in fact, it is one of the 
most uncomfortable methods that we use, but at the 
same time one of the most effective. 

6. Mento-spinous Method. (Patient sitting.) (See 
Illustration, page 49 1 . ) — This method is similar in principle 
to the mento-rotary method described below, but is a 
method that may be used while the patient is in a 
sitting position. 

It consists of a rotary method, in which the chin and 
spinous process are held as described below: 

Position. — The patient sits on a chair, bench or 
stool, while the operator stands behind. 

We will suppose, for example, that the first thoracic 
spinous process is to the right. Then we will support 
the second spinous process upon the left side with the 
thumb of the left hand. 

Extend the right hand on the right side of the neck 
of the patient and grasp the chin. 



Upper Thoracic Methods. 491 




Mento-spinous method. 



492 Spondylotherapy Methods. 

The chin, then, is rotated to the right, which rotates 
the spinous process of the vertebra of the upper portion 
of the spinal column to the left. 

A lateral thrust is given with the thumb supporting 
the spinous process. While the support is applied to the 
spinous process of the second thoracic vertebra, the 
movement tends to rotate the spinous process of the 
first thoracic vertebra into perfect alignment. 

Change hands. Use the thumb of the right hand to 
support the first spinous process upon the right side. 

Extend the left hand on the left side of the neck to 
catch the chin and rotate it to the left. 

A side rotary movement of the head and neck will 
tend to rotate the vertebra of the upper portion of the 
neck to the right. 

This will correct the relation existing between the 
seventh cervical and first thoracic vertebra, as the first 
thoracic is supported and not permitted to rotate. 

7. Mento-rotary Method. (Patient prone.) (See 
Illustration, page 493.) — This method of procedure is an 
effective way, and a fairly easy one of opening up the 
articulations in the lower cervical and upper thoracic 
regions. 

Efficiency in this method of adjustment is easily 
acquired. We will describe the technique as follows: 

Position. — The patient lies in the prone position, 
the face being turned to the left side. 

The thumb of the right hand of the operator catches 
against the right side of the spinous process of the ver- 
tebra to be adjusted and supports it. 

The left hand of the operator catches and raises the 
chin of the patient. Forces applied to these two points 
of contact should be in opposite directions. 

This rotates the upper portion of the spine, and the 
support given to a spinous process will cause a loosening 



Upper Thoracic Methods. 



493 




Mento-rotarv method. 



494 Spondylotherapy Methods. 

of the articulation immediately above the supported 
spinous process. 

The face may be turned toward the right, while the 
spinous process is supported upon the left side. Then 
a rotary movement would open up the articulation above 
the supported vertebra. We rotate it in the opposite 
direction; we then loosen up the articulation on the 
opposite side. 

This is a very convenient method to use as the patient 
lies prone upon the table, and is also a very effective, 
comfortable, and painless method. 

8. Occipito-SpinousMethod. (Patient sitting.) (See 
Illustration, page 495.) — The occipito-spinous method is 
similar to the one described above, but varies in the 
manner of the contact and technique. 

Position. — The patient remains in the sitting position 
upon a chair or stool, while the operator stands behind. 

The left hand is used to support a spinous process 
upon the left side, while the right hand is used to support 
a spinous process upon the right side of the upper thoracic 
region. 

In either case, the other hand is placed against the 
occiput of the head. 

The head is flexed forward; a side thrust is given to 
the occiput, throwing the head to the side to which a 
support is given to the spinous process by the other hand. 

The side thrust is also slightly rotary in nature and 
the more rotary the movement the better. 

This will open up the articulation above the vertebra 
which has its spinous process supported. 

This method is a very effective way of loosening up 
the articulations of the upper portion of the thoracic 
region, and is not painful. It is not as effective as the 
lateral method, described above, for the reason that 
when the head is flexed forward, the erector muscles of 
the spine are brought into action, and it is necessary to 



Upper Thoracic Methods. 



495 




Occipito-spinous method. 



496 Spondylotherapy Methods. 

overcome the muscular resistance in order to execute a 
successful adjustment. 

9. Old Method — Forward Thrust. (Patient prone) . 
(See Illustration, page 497.) — This is a very simple and 
very crude method of procedure, and may be described as 
follows : 

Position. — The patient lies prone upon the adjust- 
ment table. Should the operator stand on the left side 
of the patient, then the patient's face should be turned 
in the opposite direction, looking toward the right. 

The pisiform bone, or ulnar border of the left hand, 
should be placed against the spinous process of the 
vertebra to which the thrust is to be given. 

The right hand is used to reinforce and strengthen 
the left hand. 

The thrust then is given forward at an angle of thirty 
to forty-five degrees, and the articulation between the 
vertebra that is thrust, and the one immediately below 
it, is opened up. 

It requires considerable force to accomplish an adjust- 
ment in this way, and owing to the curvature of the 
spine, it is hard to get a proper contact against the 
spinous process, so it is not only crude, but a very difficult 
method to execute. 

10. Old Method — Backward Thrust. (Patient 
prone.) — Owing to the curvature of the spine, some 
have sought to overcome the difficulty of obtaining a 
contact against the spinous process, by changing the 
position of the operator and the direction of the thrust 
which is applied. 

Position. — The patient lies upon the adjusting table 
in a prone position. 

The operator stands at the head of the patient, while 
the face is turned to the right or to the left. 

The adjusting hand of the operator is placed against 
a spinous process of the upper thoracic region, and a 



Upper Thoracic Methods. 



497 




Old upper thoracic method. 



498 Spondylotherapy Methods. 

thrust then is given downward and slightly backward, 
instead of forward. 

This method is very, very crude, very ineffective, and 
one of the poorest methods we have ever seen used. 

Personally, we do not use this method any more, as 
we have so many methods, far superior ones to this in 
every way. 

A modification of this method we find to be excellent 
in some cases. The position of the patient and the 
operator are the same as described above. The contact 
is made by the ball of the thumbs or may be made by 
the use of the pisiform processes, upon the transverse 
processes of an upper thoracic vertebra. In this manner 
the transverse processes of either of the upper thoracic 
vertebrae may be thrown downward or both anterior and 
inferior. The application may be made and the thrust 
applied to both of the transverse processes of a vertebra, 
or we may apply the thrust upon either side instead of 
both sides. 

11. The Occipito-Spinous Thrust. (Patient prone.) 
(See Illustration, page 499.) 

Position. — The patient lies in a prone position on the 
adjusting table with face lying toward one or the other 
side. The position of the operator is at the side of the 
patient's body. 

Contact. — The thumb of one hand is placed against 
the spinous process, on the side opposite to which it 
should be adjusted. 

The occiput of the patient is turned toward the side 
on which the contact with the thumb is made. 

The other hand is placed on the occiput of the patient, 
thus making the spinous and occipital contact. 

Suppose we are wanting to throw the spinous process 
of the first, second or third vertebra toward the right: 

Position. — We may stand to the left side of the 
adjustment table and body. 



Upper Thoracic Methods. 



499 




Occipito-spinous method. 



500 Spondylotherapy Methods. 

Patient lies with his face to the side opposite the 
operator and with the occiput of the head toward the 
operator. 

With the thumb of the left hand we support the first, 
second, or third thoracic spinous process upon the left 
side. 

The right hand is placed upon the occiput of the 
patient. 

The slack is all taken out by a rotary movement 
rotating the occiput to the left, and the spinous process 
which is supported is thrust toward the right side. 

A slight thrust now in the two directions in which we 
are rotating the spine and occiput will easily accomplish 
the desired adjustment. 

If the spinous process of an upper thoracic vertebra is 
to the right side instead of the left, and we wish to throw 
it towards the left to bring it into normal alignment, then 
we reverse our hold and the hand used in contact with 
the spinous process and occiput. 

We use the thumb of the right hand against the right 
side of the spinous process of the vertebra to be adjusted. 

The left hand then should be placed in contact with 
the occiput. 

The occiput in this case is turned to the right, while the 
face is turned toward the left. 

Rotate sufficient to overcome all slackness and at the 
same time we support the spinous process of the vertebra 
with the thumb of the right hand. This will cause a 
loosening up of the articulation between the vertebra 
which has its spinous process supported and the one 
immediately above it. This is a very easy and effective 
way and much superior to that used by the ordinary 
practitioner or teacher of spinal adjustment. 

Instead of using the thumb against the spinous pro- 
cess of the vertebra to be adjusted, we may now use the 
pisiform bone as a point of contact against the transverse 



Upper Thoracic Methods. 501 

or spinous process; in this case the point of contact is 
changed from the thumb to the pisiform bone and to the 
ulnar border of the hand. 

The pisiform bone contact may be made upon the 
transverse process in the middle and upper cervical 
regions in making adjustment. 

Position. — The patient lies prone with the head on 
the left side, and with the face to the right and from the 
operator. 

The operator places the left hand with the pisiform 
bone in contact with the transverse processes of the 
cervical vertebrse. 

The operator's right hand catches the head or occiput 
and rotates sufficient to overcome slack and then by a 
slight thrust we may make the desired adjustment. 



CHAPTER VII. 
GENERAL THORACIC METHODS. 

IN this chapter we wish to consider briefly a number 
of different methods, which may be used in the 

adjustment of a patient, in the thoracic region. 
There are many different methods which may be and 
which are used. 

The author of this work was first trained to use but 
one method, but by travel and by exchanging ideas with 
other practitioners, and by a study of the methods used 
by the Bohemians, we have enlarged our store of knowl- 
edge along this line until we are now using and teaching 
more than fifteen different methods of adjustment of the 
thoracic vertebrae. 

We are thankful to many for the greatly increased 
knowledge we have obtained since our early education 
in spinal treatment, and we are glad to present to our 
readers the description of so many excellent methods of 
adjustment of the vertebras in the thoracic region, for 
the reason that we wish to make them proficient in the 
science and art of spinal adjustment because of the great 
good that can be accomplished by the efficient use of this 
method of treatment. 

In the description of the methods of adjustment, we 
desire to be specific, and to make the instruction com- 
prehensible, and in order to do so, with each method of 
adjustment we furnish special illustrations which are 
prepared especially for this work. 

1. Recoil method. 

2. The knee thrust. 

3. Shepherd methods. 

4. Pisiform contacts. 

5. Rib thrust methods. 

502 



General Thoracic Methods. 503 

6. Ulnar border contact. 

7. Spinal swaying method. 

8. Hollow of hand contact. 

9. Bimanual rotary methods. 

10. Standing in front method. 

11. Thumb on spinous process. 

12. Knuckle between transverse. 

13. Thumbs on transverse processes. 

14. Pisiforms on transverse processes. 

15. Ball of thumb contact, spinous process. 

1. Recoil Method. (Patient prone.) — We mention 
this method first, but are free to confess that we believe 
it is last and least in importance. It is based upon a false 
conception of what constitutes a subluxation, and also 
a false conception of what is to be accomplished when 
giving the thrust to the process of a vertebra. We believe, 
however, that this ridiculous method of adjustment is a 
fair sample of the knowledge and competency of its chief 
exponents who do not comprehend the nature or philoso- 
phy of spinal lesions or of their adjustment. 

This adjustment is based upon the idea that the 
vertebrae slip here and there, around and about, and 
under the influence of a quick jar they flip, flap or flop 
accidentally, perchance, or, by some other mysterious 
way, back into place and into normal relation with their 
fellows. 

The technique of this operation consists of a number 
of preliminary contortionary acts which would be hard 
to describe with a pen. 

The recoil, however, might be described as giving a 
quick thrust and making a double quick getaway in order 
that the hand may not obstruct the accidental, may be 
so, perchance, slipping, flipping, flopping of the vertebras 
back to where they belong or somewhere else, the Lord 
only knows where. We pass this, however, without a 
minute detail of the technique, for fear some prac- 



504 Spondylotherapy Methods. 

titioners of spinal adjustment may not have better 
judgment than to use it. 

2. The Knee Thrust. (Patient sitting.) The knee 
thrust method is a simple one, and one that has been 
used to a certain extent in a manner by our osteopathic 
brother. 

We consider it a very indefinite method, and one that 
we do not use ourselves, because of the fact that we 
would never know what we were doing when using it. 
The technique is something like the following: 

Position. — The patient sits on a stool, while the 
operator stands at the back. 

The operator raises the arms of the patient, while 
the knee presses against the vertebrae of the spinal column. 

As the arms are drawn up, the spine is straightened, 
the pressure of the knee against two or three vertebrae 
of the spine will tend to loosen up the articulations. By 
being careful that the patella of the knee approximates a 
certain vertebra, we may feel fairly confident of loosening 
up the articulations of that vertebra with its fellows, 
especially of its articulation with the adjacent one above. 

We can apply the knee to either side of the spinous 
process, and sometimes by means of this movement may 
accomplish some good in spinal curvature. 

We feel, however, that more specific methods of adjust- 
ment are far superior to the knee thrust, and we do not 
believe it will be used except by those who are crude in 
their methods, or used as a general method, by those 
who are not doing specific spinal adjustment. 

3. Shepherd Method No. 1. (Patient standing.) 
(See Illustration, page 505.) — This is by no means a specific 
method of spinal adjustment. It is a crude method of 
opening up the spinal articulations, but it is practically 
a painless method, and may be used anywhere and at 
any time. The following explanation will describe briefly 
the technique of this procedure: 



General Thoracic Methods. 



505 




Shepherd method (Bohemian). 



506 Spondylotherapy Methods. 

Position. — The patient stands erect, and relaxed, 
while the operator stands at the back. 

The patient locks the hands together at the back of 
his neck. 

The operator passes his hands under the arms of the 
patient and catches over and around his wrists. He then 
lifts the patient off of the floor. 

The lifting movement alone may open up some of the 
articulations of the thoracic region. 

The efficiency of this movement would be greatly 
enhanced if, when the operator lifts the patient, he 
would give a quick jerk of the body. This will open up 
several of the articulations of the thoracic vertebrae 
almost simultaneously. 

There is one objection to this method, and that is, 
should there be a contractured condition of the spine, 
then perhaps that portion would not relax as easily as 
the musculature of those articulations which are more 
nearly normal. 

We have succeeded a number of times in giving 
almost instant relief by this procedure, and since this 
method of loosening up the vertebrae causes no pain 
whatever, it is a method worthy of consideration and 
one that should be used more frequently than it is at 
present. 

Shepherd Method, No. 2. (Patient standing.) (See 
Illustration, page 507.) — In some cases this works more 
satisfactorily than No. 1. This method is not quite so 
easily given, for the reason that the operator cannot get 
so good a hold upon the patient. We find, however, that 
we can get a more decided effect upon the upper 
thoracic vertebrae by this process than by the other. 

Position. — The patient stands erect with the hands 
folded and over the eyes, while the elbows are down in 
front of the chest. 

The operator stands behind the patient; reaches 



General Thoracic Methods. 507 



Shepherd method (Bohemian). 



508 Spondylotherapy Methods. 

around the body and around the elbows and grasps the 
patient. 

The operator then lifts the patient off the floor, and 
by the mere act of lifting, he will often loosen up the 
articulations of vertebrae. 

As above stated, by giving a jerk of the patient after 
he is lifted, the effects of the method may be greatly 
enhanced. A light person can lift and adjust in this 
way a heavy person with a great deal more ease than 
would be apparent, and these methods have the advantage 
of being available for use without any equipments or 
appliances. 

4. Pisiform Contact. (Patient prone.) (See Illus- 
tration, page 509.) — The pisiform method of contact with 
the spinous process is not to be recommended for general 
use, because it is a very imperfect contact, and it is almost 
impossible to use it with any precision except in certain 
regions. 

In the lumbar region, where the spinous processes are 
large, the pisiform contact is an excellent way of apply- 
ing a thrust to one side in cases where the spinous pro- 
cesses are out of perfect alignment. 

In the cervical region and in the dorsal region such a 
method of procedure is very indefinite in its results. The 
pisiform contact is only an effort to change from the ulnar 
border contact, which will be described below and thus 
appear to be original. The technique of this operation 
is very simple, yet difficult to describe. 

Position. — The patient lies in the ordinary prone 
position upon the adjustment table, the operator stand- 
ing upon either side. We will suppose the operator 
stands upon the left side of the patient, for example. 

The pisiform process is applied to the left side of the 
spinous or to the posterior edge or the upper edge owing 
to the direction the process is supposed to be thrust. 



General Thoracic Methods, 



509 




Pisiform contact (method No. 4). 



510 Spondylotherapy Methods. 

The right hand catches around the wrist of the left 
hand. 

The tips of the fingers also rest upon the spine to 
help to retain the pisiform bone in position and prevent 
the movement of the hand on the skin of the flesh. 

A thrust is then given which will throw the spinous 
process away from the point of contact of the pisiform 
bone, or at least such a movement is intended. 

If the pisiform contact is placed in the right contact 
in the lumbar region, it is an effectual method of giving 
a thrust in some cases. If, however, this manner of con- 
tact is used in the thoracic region, it is quite indefinite 
owing to the small point of contact in most cases. 

In order that we may give a thrust from the opposite 
direction or side, the pisiform bone may be applied to 
the other side of the spinous process. 

Either hand may be used on either side of the spinous 
process in the pisiform contact, the principal point to 
be observed being the position of the hand and the side 
to which the thrust is administered. 

5. Rib Thrust Methods. (Patient sitting.) (See 
Illustration, page 511 . ) — The rib thrust method is a method 
of adjusting a thoracic vertebra by means of contact 
and with a thrust given to the ribs. 

This method has been used, and to good advantage 
in some cases. The rib thrust is intended to throw the 
thoracic vertebrae backward instead of forward, as they 
are thrown by the ordinary methods of adjustment. 

The ribs are flexible, and, in old people, easily broken, 
and for this reason a certain precaution should be taken 
when using the rib thrust methods. 

There are different ways of applying the rib thrust, 
but we will describe but one in this connection. 

Position. — The patient sits on a stool, while the 
operator stands at his back. 

Place a strong band of some kind around the chest, 



General Thoracic Methods. 511 




Rib thrust, thoracic method (Bohemian), 



512 Spondylotherapy Methods. 

and draw the end of the band back under the arms on 
each side. 

If the band is around the fifth rib, then support the 
sixth vertebra by contact against the spinous process 
thereof with the knee. 

A backward thrust is then given by means of the 
band that encircles the body. The thrust is applied to 
the rib, but the sides of the ribs are supported by the same 
band that gives the thrust. In this way danger of 
springing or fracturing the ribs is avoided. 

You will hear a decided click when the articulation 
loosens up, and this is because of a backward movement 
of the vertebra to which the ribs are attached. 

It is necessary to be careful in applying the support 
to the spinous process of the sixth thoracic vertebra 
when the thrust is given to the rib of the fifth, to protect 
from bruising or hurting the tissues. 

We have used a pad with a deep crease in the center, 
and applied the knee to the pad, while the spinous pro- 
cesses of the vertebra fit into the crease. 

The upper end of this pad should not go higher than 
the transverse processes of the sixth vertebra in order 
that the fifth may move backward without being inter- 
fered with. 

This method is comfortable, effective, and should be 
used in the straight back, and in anterior conditions of 
any of the central thoracic vertebrae. The Bohemians 
administer this treatment by reaching around the body 
with their hands, and placing their heads to support the 
vertebra below the ones to which the ribs are attached, 
to which the thrust is given, or just above the vertebra 
to be adjusted backward. 

6. Ulnar Border Contact. (Patient prone.) (See 
Illustration, page 513.) — This is a very commonly used 
method among those who practice spinal adjustment. 
The technique may be described as follows: 



General Thoracic Methods. 513 




Ulnar border contact (method 6). 



514 Spondylotherapy Methods. 

Position. — The patient lies in a prone position, upon 
the adjustment table, the operator standing upon either 
side of the patient. 

The face, by preference, is turned to the opposite 
side, as this movement rotates the spinous processes 
more in line with the operator. 

While standing on the left side, apply the ulnar border 
of the left hand to the spinous processes of the vertebra 
that is to be adjusted, or that is to be loosened from its 
approximation to the one immediately below. 

The ulnar border is soft, and for this reason protects 
the tissues over the spinous processes and gives better 
control than the pisiform contact. 

In reinforcing the left hand, in this method, the 
fingers of the right hand should be folded and placed 
upon the back of the left hand, and a little posterior to 
the point of the ulnar contact. 

The hand should lay as flat upon the back as possible 
to prevent the hand from slipping or moving upon the 
back, and the contact greater. 

The reinforcement of the right hand will direct the 
thrust to the proper point through the contact hand. 

Should the hand stand on edge, then it will appear 
sharp to the patient and involuntary reflex contractions 
will prevent the relaxation necessary to obtain a success- 
ful adjustment. 

This method is used on practically all of the spinous 
processes of the thoracic vertebrae, except the first one or 
two. It is possible to direct the force of the thrust to 
the right, to the left, or forward or downward by the 
use of the ulnar contact and to make the contact also 
upon the transverse processes very slightly. 

7. Spinal Swaying Method. (Patient prone.) (See 
Illustration, page 515.) — This is not a method of adjust- 
ment so much as it is a preparatory method in which we 



General Thoracic Methods, 



515 




516 Spondylotherapy Methods. 

loosen up the lateral spinal musculature on the sides 
of the vertebral column. 

Position.— The patient lies on the bifed adjusting 
table, in a prone attitude especially prepared for this 
purpose. The face is placed in a bootjack opening in 
the front end of a table that is especially prepared for 
this purpose. 

The front part or section of the table supporting the 
chest should rest on the back legs only. 

The operator stands at the head of the patient and 
rotates the shoulders and head to either side by rotating 
from the front end of the table, and by so doing affects 
the spine by flexing it from side to side. The spine will 
flex in any portion, and we are enabled to determine 
which portion flexes most by supporting a certain segment. 

For example, if we wish to loosen the musculature of 
the middle thoracic region, we have only to support 
directly the spinous processes in that region, and press 
against the movement of the body in rotating. 

This will cause a decided flexure of that portion of 
the spine where it is supported, but the musculature of 
the opposite side of the spine will be affected by stretch- 
ing them. This is a very useful method in spines that 
have been settling, and growing stiff for years. 

By the persistent use of this method from day to 
day, the musculature of the spine may be loosened up, 
and the spine may become as supple as it should be 
normally. 

It may be best in using the method of spinal swaying 
to have a strap to hold the hips stationary, while the 
shoulders are swayed from side to side. 

The patient may exercise himself in this way by 
certain movements, while he stands and bends in 
different ways, and it is the movements that relax the 
spinal musculature that are most beneficial in physical 
culture methods. 



General Thoracic Methods. 517 




Hollow of hand method. 



518 Spondylotherapy Methods. 

Lateral flexion of the spine is undoubtedly beneficial 
for the maintenance of the normal elasticity of the 
lateral spinal musculature. 

8. Hollow of Hand Contact. (Patient prone.) 
(See Illustration, page 517.) — This is one of our best 
methods, and possesses several advantages over the 
ordinary methods of adjustment in that it gives better 
control and the contact is more comfortable to the 
patient and the adjustments are more easily made when 
using this contact. 

Position. — The patient lies prone upon the adjust- 
ment table. 

Preferably, the shoulders should be lower than the 
hips. 

This condition may be obtained by having the table 
properly prepared, with the front section lower than the 
hind section. 

The operator may stand upon either side of his 
patient. 

If he should stand upon the left side of the patient, 
it would then only be convenient for him to use the right 
hand for making the contact with the spinous processes 
of the patient. 

The spinous process, to which a thrust is to be applied, 
should fit in the center of the hollow of the hand. 

The hand should lie flat upon the back, with the 
fingers extended toward the patient's head. The ball of 
the thumb and the ulnar border of the hand then come in 
contact with the transverse processes and this makes the 
contact more agreeable. 

The thrust then may be directed downward, forward, 
backward, or to either side, at the will of the operator. 
This method of adjustment has many advantages: 

1. You have absolute control of the spinous process, 
and can carefully direct the thrust in any direction 
desired. 



General Thoracic Methods. 



519 




Bimanual rotary method. 



520 Spondylotherapy Methods. 

2. The hand lies flat upon the patient, and in con- 
tact with the spinous and transverse processes, and no 
sharp feeling at the point of contact will produce reflex 
contractions and prevent the adjustment, as in the 
pisiform, and other uncomfortable methods of contact. 

3. The pad of the muscles in the hollow of the hand 
will not injure the tissues over the spinous processes and 
make them sore. 

4. The ball of the thumb and the ulnar border of the 
hand will rest upon the transverse processes of the ver- 
tebra, and form a triple contact, one being that of the 
spinous process in the hollow of the hand, and the other 
two being those parts upon the transverse processes. 

A trial sufficient to become familiar with the use of 
this contact will convince any one of the efficiency and 
the advantages of this method of adjustment. 

Personally, we feel that it is one of the best methods 
of contact that we use; none better, except it be a subse- 
quent method, which we wish to describe below. 

9. Bimanual Rotary Methods. (Patient prone.) 
(See Illustration, page 519.) — This is a useful method in 
many cases. The technique of it is simple. 

Position. — The patient should lie in the regular 
prone position for adjustment, and the application is by 
the use of the pisiform bones of the two hands. 

If the pisiform contact is used, it may be applied in 
the following manner: 

The pisiform bone of the right hand is applied to the 
proximal transverse process in such a way as to thrust 
it forward. 

The pisiform bone of the left hand is placed against 
the distal transverse process in such a way as to thrust 
it backward. 

A simultaneous thrust is given to the inferior border 
of the process upon the proximal side, and the superior 



General Thoracic Methods. 521 

border of the other transverse process of the same ver- 
tebra upon the distal side. 

By this means, we thrust one transverse process in 
one direction, while the other is thrust in the other direc- 
tion. This is used sometimes in crooked spines in order 
to correct the alignment of the vertebral spinal processes. 

The hands may be folded and the knuckles may be 
used in contact with the transverse processes instead of 
using the pisiform contact, but this is not so effectual in 
producing any rotary effect. 

10. Standing in Front Method. — This method is 
seldom used, and seldom does the occasion demand it, 
and also because it is not as specific and agreeable as 
other methods. 

We describe it, however, as there may be circum- 
stances in which it may be a valuable method of pro- 
cedure. 

Position. — The operator should stand in front of 
the patient. 

The upper portion of the chest of the patient is 
brought against the chest of the operator. 

The hands encircle the body, and a contact is made 
with the border of the thumb below and against the 
process to which a thrust is to be given. A quick thrust 
caused by tightening the hands encircling the body, will 
then make the adjustment. By the use of this method, 
we may adjust the thoracic vertebras from the fourth 
down to and including the tenth, with comparative ease. 

11. Thumb on Spinous Process Method. (Patient 
prone.) — This is a method that may be used anywhere 
in the lumbar, and almost anywhere in the thoracic 
regions, but is more difficult to use in adjusting the 
upper thoracic vertebras . 

The patient's body may be lifted by catching around 
the body under the arms. 



522 Spondylotherapy Methods. 

The body is rotated to one side, while the thrust 
supports the spinous process of a certain vertebra. 

As the body rotates, there is a tendency to open up 
the articulation between the vertebra that is supported 
by the contact with the spinous process, and the one 
immediately above which tends to rotate with the body 
as the vertebra above the contact partakes in the general 
rotation of the spine produced by the upward lift and 
rotation of the body. This works very well in the lumbar 
region, and is often used by the osteopath physician in 
adjusting the lower thoracic vertebrae. 

12. Knuckles Between Transverse. (Patient 
erect.) — This is an effective method in many cases of 
loosening up the articulation between the adjacent 
vertebrae upon one side, and is used in the case of 
spinal curvature. 

The patient should be lifted so as to hold the weight 
of the body, while the knuckle is pressed between the 
transverse processes upon the side that is contracted. 

If there is a scoliosis, or lateral curvature of the 
spine, then the knuckles should be pressed between the 
transverse processes upon the concave side of the spine. 

This is a method that is used by some practitioners 
of spinal treatment, and, from the best we can learn, this 
is a similar method to one that is used sometimes by 
Dr. Reese, of Youngstown, Ohio. 

13. Thumbs on Transverse Processes. (Patient 
prone.) (See Illustration, page 523.) — This is a method 
that is frequently used, and is best done by the fol- 
lowing method: 

Position. — The patient lies prone in the ordinary 
position for spinal adjustment upon the treatment table. 

The operator stands on either side of the patient to 
make the adjustment. 

By crossing the thumbs and spreading them over the 
spinous process and by applying them to the transverse 



General Thoracic Methods. 



.523 




Thumbs on transverse processes (method 13). v 



524 Spondylotherapy Methods. 

processes on either side, a fairly comfortable contact is 
obtained. 

The thrust, then, is applied to the transverse processes, 
usually thrusting them downward and forward. A sound, 
as of opening up a synovial joint, is distinctly heard, 
and many use this method of adjustment almost exclu- 
sively because it is not painful to the patient. 

This method is not only not painful, but it is thought 
by some to be a very effectual method in loosening up 
the vertebral articulations. We are not sure, however, 
that we always loosen up the articulation between the 
vertebrae, but may, instead of doing so, open up the 
articulations of the ribs with the transverse processes. 

We know there exists a synovial sac between the 
articular surface of the ribs and the centrum and trans- 
verse processes of the vertebrae, and we are sure that a 
sound may be produced by separating these synovial 
membranes, and we are confident that often this sound 
is mistaken for the sound of the opening of an articulation 
between the vertebrae. 

14. Pisiforms on Transverse Processes. (Patient 
prone.) — This is a method in which we make the pisiform 
contact on both sides of the spine and thrust the trans- 
verse processes in the same direction. This may be 
done in the following manner: 

Position. — The patient lies in the ordinary prone 
position upon the adjustment table. 

Operator stands either upon the right or left side of 
the patient. 

The hands are crossed, and instead of applying the 
thumbs, the pisiform processes are placed in contact with 
the transverse processes of the vertebrae, and with this 
contact the thrust is given. 

This is rather an awkward method, and hard to get 
a good contact on both sides at the same segment of the 
spine, and for this reason this method is seldom used. 



General Thoracic Methods, 525 




Ball of thumb contact method. 



526 Spondylo therapy Methods. 

In fact, we consider it inferior to using the thrusts upon 
the transverse processes of the vertebra. 

15. Ball of Thumb Contact. (Patient prone.) (See 
Illustration, page 525.) — This method of contact of the 
hand with the spinous processes is one of our favorite 
plans in ' giving thrusts in the thoracic region from 
the upper lumbar all the way up to the third thoracic 
vertebra. 

Position. — The patient is placed in the prone position 
upon the ordinary adjustment table, while the operator 
stands on either side of the table or patient. 

If the operator stands on the left side of the patient 
then he may use the ball of the thumb of the left hand as 
the point of contact against the spinous process to which 
the thrust is to be given while the same point of contact 
of the right hand is placed immediately over the spinous 
process to be adjusted, and over the contact portion of 
the other hand. The right hand in this case is so placed 
for the purpose of reinforcing the strength of the left 
hand. 

The thumbs and fingers of both hands spread out over 
the back of the patient and thus form a large surface of 
contact so that the patient is not enabled to tell where 
the force of the thrust is to be given. This is not a sharp 
or unpleasant contact and in fact is one of the most 
pleasant contacts we use, and it tends to induce perfect 
relaxation of the musculature of the spinal column and 
a most favorable condition for the administration of an 
effective thrust. 

In all the other methods of adjustment, when giving 
a thrust while using other points of contact, the procedure 
is the same as when using the method of contact just 
described. 



CHAPTER VIII. 
LUMBAR METHODS. 

THE lumbar vertebrae are the largest osseous struc- 
tures in the spinal column. They constitute, as it 
were, the base of a pyramid which is made up of 
the vertebras of the entire spinal column. 

The musculature of the lumbar vertebrae is perhaps 
the strongest and most perfectly developed of any in 
the body. This is a provision that compensates in a way 
for the strain and superimposed weight which rests upon 
them, which is heavier upon the lumbar vertebrae, than 
any vertebrae above in any other region. 

The lumbar vertebrae are not supported by ribs as 
those of the thoracic region, and for this reason the 
additional strength, in this portion of the spinal column, 
is necessary to supply ample protection. 

As would be supposed, it requires a heavier thrust and 
a more effective one to loosen up the lumbar vertebral 
articulations, than those of any other portion of the spine. 

Many devices have been sought to enable us to loosen 
the vertebral articulations of the lumbar regions. Some 
of them are good, and we hope to bring to your attention 
a few methods of relaxing the musculature and of loosen- 
ing up the articulations of the lumbar vertebrae which 
will be practical and efficient, and more satisfactory 
than the former method so generally used by practitioners 
of spinal adjustment. 

One of the first considerations is to get the patient 
into a position so that the lumbar adjustment may be 
easily and successfully made. This has caused consider- 
able study and experiment on the part of those practicing 
spinal adjustment, and different methods and plans have 
been originated and recommended. In this connection, 

527 



528 Spondylotherapy Methods. 

we wish to describe a dozen or more methods of relaxing 
and loosening up the lumbar vertebrae in general, and 
also enumerate a few special methods of adjustment of 
the fifth lumbar. 

The first thing we wish to consider in this connection, 
is the part of the hand which should be used in contact 
with the spinous process when making adjustments of 
the lumbar vertebrae. We have four points of contact 
which are principally used: 

1. Ulnar contact. 

2. Thumb contact. 

3. Pisiform contact. 

4. Hollow of hand contact. 

Besides the above four methods, we adjust the lumbar 
vertebrae without any contact with the spinous process 
of the vertebrae themselves, simply using the extremities 
as levers for body movements, and in this way we bring 
about adjustment by the rotary methods which loosen 
up the spinal articulations generally, but not specifically 
as we often wish to do. 

1. Ulnar Contact. — This contact is perhaps used 
as much as any other, and it has this advantage: We are 
enabled to get the ulnar border of the hand between the 
spinous processes, or behind the spinous process to be 
adjusted in a specific manner, and the ulnar contact 
furnishes a soft cushion and comfortable contact with 
the patient's lumbar region if it is perfectly applied. 

We have an advantage, also, in that the thrust may 
be given in almost any direction desired. From the 
standpoint of convenience and of universal application, 
this is perhaps the most practical method of making the 
lumbar adjustment in many cases. 

2. Thumb Contact. — The thumb contact is used in 
connection with certain methods of lumbar adjustment, 
and can only be used when a side movement of a spinous 
process is desired and may be best accomplished by a 



Lumbar Methods. 529 

rotary movement of the body while the contact is made 
against the spinous process with the thumb holding one 
spinous process stationary, while the spinous process and 
vertebrae above it are rotated. 

If we find, in the lumbar region, any failure of the 
proper alignment of a spinous process, it is a positive 
sign of a spinal lesion or subluxation. In the illustra- 
tions of methods of adjustment below, the method of 
using the thumb contact is well illustrated. (See Illus- 
tration, page 525.) 

3. Pisiform Contact. — The pisiform contact is a 
very useful method in giving a lumbar adjustment. In 
fact, this is the only region where the pisiform contact 
can be used successfully and with any degree of accuracy. 

The spinous processes in the lumbar region are large 
and they are quadrilateral in form. For this reason we 
can obtain a pisiform contact against either of the four 
surfaces, and this enables us to throw the spinous pro- 
cess in any direction desired. 

In lateral conditions of a spinous process in the 
lumbar region, the pisiform contact is an excellent way 
to relax the musculature that is drawing the vertebrae 
out of proper alignment. This is one of our best methods 
of contact in the lumbar region, but we discountenance 
the use of this contact in any other segment of the spine, 
because of the superiority of other contacts. 

4. Hollow of Hand Contact. — The hollow of the 
hand contact is a most useful method in all portions of the 
spine, and this works well in the lumbar region, especially 
in the adjustment of the upper lumbar vertebrae. The 
first, second, third, and even the fourth lumbar vertebrae 
may be adjusted easily by the use of the hollow of hand 
contact. This has the advantage of being a comfortable 
contact, and consequently one that does not excite 
resistance by causing involuntary muscular contraction. 

As remarked above, we often loosen up the articula- 



530 Spondylo therapy Methods. 

tions of the lumbar region without making any direct 
contact with the processes of the lumbar vertebrae. This 
may be done in different ways by using one of the lower 
limbs as a lever, by using the trunk as a lever, by a thrust 
upon the sacrum, with the patient over a roll, or by a 
thrust upon the shoulder while the patient remains 
sitting flexed in a proper attitude. 

These methods of loosening up the lumbar articula- 
tions are not so universally specific as the direct thrust, 
but they have the advantage of being less painful; in 
fact, in most cases, these plans of adjustment are painless 
methods of loosening up the lumbar articulations and 
are therefore to be commended. 

There is another important consideration in lumbar 
adjustment, and that is the matter of securing the 
relaxation of the musculature of this portion of the 
spine, that we may be enabled to open an articulation 
more easily. It is an impossibility to have any decided 
effect or make a successful adjustment of the lumbar 
region when the musculature thereof is tensed, or in a 
tonic state of contraction. 

The musculature of the posterior surface of the spine 
must at least be relaxed before we will be able to get any 
loosening up of the articulations of the lumbar vertebrae. 
Different methods have been used to secure relaxation. 
As a preface to the study of lumbar methods of adjust- 
ment, we call attention to different methods of procedure 
to secure relaxation of the musculature of the lumbar 
region : 

1. Bifed table method. 

2. Over a roll method. 

3. Raising limb method. 

These are the principal methods of securing relaxa- 
tion, that have been, and are now being used in giving 
the specific thrusts. 



Lumbar Methods. 531 

Bifed Table Method. — The Bifed table method was 
the first one used by the Americans, to secure the 
relaxation of the musculature of the lumbar region for 
the purpose of making an adjustment of a lumbar 
vertebra. 

This method consists of having the two sections of 
the Bifed table, back and front, arranged so they may 
be separated. The chest of the patient, and the knees 
or thigh, rest upon the proximal ends of the two sections 
of the Bifed table, while the body is suspended between 
the sections. 

Some patients are able to relax in this way, and when 
the erector muscles of the spine are completely relaxed, 
we are enabled to get a loosening up of the articulations 
of the lumbar region by a direct thrust. 

A great many practitioners of spinal adjustment are 
still using this method, and in many cases it works 
remarkably well. There is an element of fear, upon the 
part of the patient, connected with the use of this Bifed 
table that prevents relaxation, and this is true with 
quite a percentage of patients. 

There is a feeling of insecurity that causes a great 
many of them to voluntarily or involuntarily contract 
the musculature of the spinal column, so that an adjust- 
ment is practically impossible, and if the adjustment is 
forced, it then becomes very painful to the patient because 
of the resistance made against it and the injury done to 
the fibrillae of the spinal musculature caused by forcing 
relaxation. 

This method of securing relaxation is open to some 
objections: 

(a) That of the element of fear on the part of the 
patient is most potent against obtaining any movement. 

'(b) There is also possibility of danger of injury to the 
spinal musculature of the lumbar region. 

When the spinal column is flexed until the posterior 



532 Spondylotherapy Methods. 

surface of the lower portion of the spine is quite concave, 
the spinous processes of the lumbar vertebrae are thrown 
into contact with each other. In some cases the spinous 
processes of the lower lumbar vertebrae normally articulate 
sufficiently for the development of synovial membrane 
between them. 

When the spinous processes are thrown so as to 
approximate each other by flexing the spine between the 
segments of the tables, then it is hard to loosen up the 
articular surface between the lumbar vertebrae without 
causing the spinous process to which the thrust is given, 
to pass to the side of the one immediately above it. This 
has no doubt been done in some instances by people who 
use the Bifed table method. The more complete the 
relaxation of the patient the more danger there is of 
thrusting a spinous process to the side of the one 
immediately above it. 

Such a misfortune would injure the ligaments of the 
lumbar region, and cause a decided contraction, which 
might give permanent trouble, unless the matter should 
be properly corrected by a competent adjuster. 

In our experience of nearly five years of spinal adjust- 
ment, we have seen but a few cases which have been 
injured in this way, and the writer has been able to 
correct some mistakes which have been made by others, 
by this method of adjustment, and we believe there is 
more trouble coming from this method than any other 
method that is used on the entire spinal column, unless 
it be the former crude methods in the lower cervical or 
upper thoracic regions. 

Over a Roll Method. (See Illustration, page 509.)— 
Some careful practitioners of spinal adjustment have, 
in an effort to get away from the objectionable method 
of dropping the patient between tables, hanging them, 
as it were, by their eyebrows in front, and their toe- 
nails on the back table, adopted the plan of elevating 



Lumbar Methods. 533 

the hips by using a roll under them. This roll is placed 
across the table and is immediately under the pelvic 
bones. This has some advantages: 

1. It raises the abdomen above the table so that it 
will not be thrust against it when the adjustment is 
made. 

2. This position also favors a separation of the spinous 
processes, as it tends to throw the spine into a curve 
backwards. This enables the operator to palpate with 
much more accuracy, and also permits a more accurate 
contact to be obtained against the spinous processes. 

These advantages are largely overcome, however, by 
the fact that in this position we are not enabled to get 
a perfect relaxation of the musculature of the lumbar 
region, hence the adjustments are difficult to get, and if we 
succeed in making an adjustment, it is apt to be more 
painful than if the adjustment was made when the 
musculature of the spine is completely relaxed. 

While the above mentioned is the best method for 
palpation of the lumbar lesions, and also the best method 
for obtaining a contact with the spinous process, it still 
falls short of being the best lumbar adjustment, by reason 
of the fact that we cannot obtain complete musculature 
relaxation with the patient in this position. 

Raising Limb Method. (See Illustration, page 335.)— 
The Bohemians use a method of obtaining relaxation of the 
lumbar region by raising the limb while the patient lies in 
the prone position. This raises the pelvis off of the floor, 
or off of the Bohemian adjuster's table, and this method, 
used by a few American adjusters, relaxes the erector 
muscles of the lumbar regions; in fact, gives us a better 
relaxation than the Bifed table method, described above. 
This is a far superior method of obtaining relaxation, as 
the patient does not resist and feel unsafe, as when he is 
suspended between two portions of a Bifed table. When 
the chest rests against the back end of a Bifed table there 



534 Spondylotherapy Methods. 

is not only an uneasy feeling and lack of comfort, but 
some danger of injury to the thoracic tissues. 

Raising the feet or lower extremities is open to 
objection, however, for the reason that the spine is 
flexed forward, and the spinous processes are thrown in 
contact with each other, and for this reason an adjust- 
ment is almost impossible without a possibility of thrust- 
ing one spinous process laterally and to one side of the 
one immediately above in some cases. 

While this method is an improvement over the 
Bifed table method, a modification of this method becomes 
at once our favorite and best method of obtaining relaxa- 
tion and making lumbar adjustment that we have used. 
The modification of this adjustment, that we have put 
into use, and have learned by experience is far superior 
to any other method of securing lumbar relaxation and 
adjustment, is as follows: 

The patient should lie over a small roll, or an elevation 
on the adjustment table, so that the abdomen is free 
from pressure or contact with the table. 

We have contrived a plan by which we drop the 
back end of the front section of the Bifed table, and in 
this way we make room for the abdominal prominence 
and at the same time sustain the pelvis in a raised position. 

To secure relaxation, we have an assistant raise one 
knee about twelve to fifteen inches high, depending on 
the flexibility of the musculature of the patient, while 
the other leg remains straight. We find this relaxes the 
lumbar musculature completely. We have often, in 
experimenting with this method of procedure, requested 
the patient to contract and resist us when we were about 
to give the thrust. The answer almost invariably is the 
same: "I can't." 

When the limb is once raised, it is impossible for the 
patient to contract the spinal musculature and resist the 



Lumbar Methods. 



535 




Raising limb, lumbar method. 



536 Spondylotherapy Methods. 

thrust successfully. This is a very important feature 
of this method of procedure. 

Again, we notice that when the musculature of the 
spine is relaxed by raising one extremity instead of two, 
that the spine is not flexed as when both limbs are raised. 
The contour of the spine is altered but slightly. We have 
in this way relaxation without flexion. This is a very 
important consideration. 

This prevents the spinous processes of the lumbar 
vertebrae approximating each other, permits a more 
specific contact to be made, and prevents the possibility 
of throwing a spinous process to the side of its fellow, 
immediately above. 

There is one other feature about this method of 
procedure that is also helpful, and that is, when the 
limb on the opposite side of the patient is raised, the 
spinous processes of the lumbar vertebrae are tipped in 
the direction of the operator, and since they are tipped 
in this direction, the operator is less apt to give a lateral 
thrust when it is not desired. In other words, it throws 
the field of operation in line with the work of the operator. 

This is a very important consideration, and leads to 
the following advice: Always raise the limb on the 
opposite side when you wish to relax the musculature 
of the lumbar region and raise but the one limb. 

After considerable experience, we are fully satisfied 
that the position and procedure just described is decidedly 
the best method of securing spinal relaxation so that we 
may succeed with lumbar adjustment with little or no 
discomfort to the patient. 

LUMBAR METHODS OF ADJUSTMENT. 

We enumerate the following methods of procedure: 

1. Old method. 

2. Side thrust. 

3. Recoil method. 



Lumbar Methods. 



537 




538 Spondylotherapy Methods. 

4. Rotation method. 

5. Thumb thrust method. 

6. Ilium thrust method. 

7. Spinal swaying method. 

The above we believe embrace the principal methods 
of procedure in making lumbar adjustment. These 
methods are combined with the different contacts and 
different methods of securing spinal relaxation, which 
we have described above. A combination of these 
methods, together with the methods of securing contact 
and relaxation, gives us a number of different methods 
of procedure in making lumbar adjustment. 

We believe that, in presenting the subject in this 
way, we are presenting it in the most comprehensive way 
we can. 

1. Old Method. (See Illustration, page 537.) — This 
method was first used in America, and was the first and 
only method that the writer used for some two or three 
years, when his attention was called to better methods, 
since which time we never use the old method. 

Position. — Patient is placed upon a Bifed table with 
a space intervening between the two sections. 

The chest rests on the front table, while the thighs 
and knees rest on the back table. This is sometimes 
expressed as follows: the patient's eyebrows on front 
table and with the toe nails on the back table. 

The patient is then instructed to relax completely, 
allowing himself to hang, as it were, or suspend between 
the sections of the table. 

When the most possible relaxation is secured, a down- 
ward movement and thrust is given, usually with the 
ulnar border or pisiform contact. This thrust movement 
consists of a double wave of impulse. 

The first movement or wave of impulse carries the 
vertebrae to the point of complete relaxation, while an 



Lumbar Methods. 539 

auxiliary wave of impulse increases the force and speed 
of the thrust, so as to open up the articulation. 

It is essential that just the right movement is given 
in making this adjustment. If the final thrust is given 
before complete relaxation is obtained, there will be no 
adjustment accomplished. The success of the adjust- 
ment depends wholly on securing, first, a thrust of slow 
velocity which carries the spine to the point of complete 
relaxation, and then of an auxiliary wave of impulse that 
follows immediately without any cessation, or latent 
period of time, between the two waves of impulse 
constituting the thrust movement. 

The second impulse simply adds to and increases the 
first in force and velocity. It is a wave on top of a wave 
of force. 

This method, however, we believe is only used by the 
practitioners of spinal adjustment whose information as 
to methods is limited, and it is fast falling into disuse, 
as the superior methods are becoming more widely known 
to the practitioners of chiropractic spondylotherapy. 

We believe there is no condition in which such an 
adjustment is advisable or best, and fully believe that 
this method of procedure should be wholly cast into 
oblivion. 

2. Side Thrust Method. (See Illustration, page 
540.) — This method of procedure consists of the following 
technique : 

Position. — The patient lies prone upon the adjust- 
ment table, which should be level, or practically so, unless 
there is considerable protuberance of the abdomen, in 
which case allowance may be made by dropping the back 
end of the front table. 

If the operator stands on the left side of patient, the 
pisiform bone of the left hand should be placed in con- 
tact with the spinous process of the lumbar vertebra, to 
which the thrust is to be given. 



540 



Spojidylotherapy Methods. 




Side thrust (method 2) 



Lumbar Methods. 541 

The right hand catches the opposite knee and raises 
it and draws it towards the operator so as to flex the 
spine, with the convexity thereof on the side of the opera- 
tor and this becomes most acute at the point of contact 
of the operator's hand. 

This movement stretches the musculature of the 
distal side of all portions of the spine as the thrust is 
given to each spinous process consecutively. 

When relaxation is secured, and flexion or swaying 
of the spine is complete as far as possible, a thrust is 
given with the pisiform bone of the left hand against the 
spinous process of each lumbar vertebra. 

The knee, which is held by the right hand, should be 
drawn, at the same instant the thrust is given, towards 
the operator, causing spinal flexion. 

A combination of the two movements of the two 
hands brings a decided leverage upon the lumbar ver- 
tebra or the spinous process thereof. 

This operation may be repeated until a thrust is 
given to each of the spinous processes of the lumbar 
vertebra?. This operation may be reversed as follows: 

The operator steps to the other side of the patient, 
and uses the pisiform bone of the right hand against the 
spinous processes of the vertebra? on the opposite side. 

The left hand catches the knee of the patient, and 
draws it toward the operator. A combination of the 
thrusts from both sides will loosen up the musculature 
on both sides of the lumbar region of the spine, and in 
case of any settled or contracted condition of the muscu- 
lature of the lumbar region, this is a very efficient method 
of procedure. 

3. Recoll Method. — This consists in applying the 
pisiform bone in some contortionate manner to some 
surface of a spinous process of a vertebra of the lumbar 
region. 



542 Sporidylotherapy Methods. 

It consists of a conspicuous preliminary procedure 
and of a very quick thrust, and of a decided recoil action 
on the part of the operator, with the hopes of having a 
consequent recoil on the part of the vertebra, by which 
it accidentally, perhaps, perchance, or in some way, hap- 
pens to fall, nip, flop, or fly into some normal or abnormal 
relation to its fellow. 

4. Rotation Method. (See Illustration, page 543.) — 
Rotary movements of the vertebrae of the lumbar region 
are very effective ways in which to open up the articula- 
tions of the lumbar vertebrae. 

Rotation of the vertebrae without any contact to the 
spinous processes, is not a very specific method, but it is 
an excellent general method of opening up one or all of 
the articulations of the lumbar region, and even affects 
some of the vertebral articulations of the lower thoracic 
region, and possesses the advantage of being an abso- 
lutely painless method in practically every case. The 
rotary movement may be described as follows: 

Position. — The patient lies on either side, with his 
arm under him or to the front of the body. 

The operator stands at the side of the adjustment 

table and to the side to which the patient's face is turned. 

The knee of the operator is thrown against the lower 

knee of the patient and supports it in a straight attitude. 

The upper knee of the patient is raised and flexed so 

that the foot catches upon the thigh of the operator. 

In this way we obtain a good leverage, by means of 
the upper extremity, to rotate the spine and loosen up 
the articulations. 

The other hand of the operator catches the patient's 
shoulder, and rotates the shoulder back, while the hips 
are rotated toward the operator. This brings a decided 
rotation of the spinal column. 

If the thrust is given to the knee, it will affect most of 
the lower lumbar vertebral articulations, directly loosen- 



Lumbar Methods. 



543 




Rotary lumbar method No. 4. 



544 Spondylotherapy Methods. 

ing up the fifth, and possibly all of the lumbar articula- 
tions, with a single movement. 

If the force is applied mostly to the shoulder of the 
patient, while the hips are held more at rest, then we 
may loosen up the thoracic vertebral articulations also 
by this method of procedure. 

The portion of the spinal column that is affected 
most, depends entirely upon the manner of the thrust or 
place of the application of the force or thrust. 

This procedure may be reversed, by the operator 
standing on the opposite side of the table, and by the 
patient facing to the other side of the table. The other 
limb then becomes the lever, the other hand is used to 
catch the knee, while the other knee of the operator is 
used to support the knee of the lower limb of the patient. 

The opposite hand of the operator catches the shoulder 
of the patient and the rotation and thrusts are applied 
in the same manner as described above. 

This we consider one of the easiest and most effective 
methods of loosening up the lumbar vertebral articula- 
tions, and a trial will convince anyone of its efficacy 
and advantages. The following rule we especially 
observe: 

If the sciatic nerve on the left side is affected, then 
we lay our patient on the left side and use the right leg 
as a lever, throwing the right shoulder back, while the 
right hip is pulled forward toward the operator. This 
will loosen up the articulation on the opposite side of 
the spine, or upon the left side where the nerve's integrity 
is involved. 

In lumbago we loosen up the articulations easily by 
this method, but we always pull toward us the leg as a 
lever upon the opposite side to the location of the tender 
nerve. In some cases we may use both limbs as levers, 
and thus open up the foramina on both sides of the 
limb. In this case we would use the limb on the side of 



Lumbar Methods. 



545 




Rotary lumbar method No. 3. 



546 Spondylotherapy Methods. 

the tender nerve, first as a lever, and second, and last, 
we would loosen up the foramina on the opposite side, 
that is, upon the side on which there were tender nerves 
by the use of the limb of the opposite side of the spine 
from the tender nerve. 

A modification of the above method may be used quite 
successfully in which the spinal musculature is not too 
well developed. It consists of having the patient lie upon 
the side with the face towards the operator, with both 
limbs straight in line with the body. 

One hand of the operator should be placed upon the 
posterior portion of the crest of the ilium, while the 
other hand catches the anterior portion of the shoulder. 

The hips are rotated toward the operator, while the 
shoulder is rotated in the opposite direction. (See Illus- 
tration, page 545.) 

This will cause a rotation of the spinal column, and 
a loosening up of the articulations between the vertebrae 
generally. 

If the thrust is most decided upon the shoulder, then 
the rotation and loosening up of the articulations will be 
most decided in the thoracic region. 

If the thrust is most decided upon the ilium, then the 
effect will be greatest upon the lower lumbar vertebral 
articulations. 

5. Thumb Thrust Method. — The thumb thrust 
method may be used in connection with a rotation move- 
ment of the spinal column, and is used considerably in 
the lumbar region by certain practitioners of spinal 
adjustment. 

If the body of the patient is raised by catching under 
the arms, the thumb may be placed against the spinous 
process of the lumbar vertebra in such a manner as to 
hold one stationary, while the segment of the spine, or 
the vertebra immediately above, would tend to rotate 
with the remainder of the spinal column above. 



Lumbar Methods 



547 




Ilium thrust method Xo. 6. 



548 Spondylotherapy Methods. 

This movement would open up the articulation be- 
tween the vertebra which is supported, and the one 
immediately above it. 

By reversing the rotation of the spinal column and 
side of point of contact, we may open up the other side 
of the vertebral articulation also. 

The thumb thrust method may be used in connection 
with the rotation of the lower extremity, and the rota- 
tion of the lower segment of the spinal column. The 
principle, however, is the same. If one vertebra is held 
stationary while the other vertebrae are rotated, the 
articulation between the one that is held stationary and 
the one above that is rotated, will be opened up, but in 
case the lower limbs are used as levers to rotate the 
lower portion of the spinal column, then the articulation 
between the vertebra supported, and the one immediately 
below it, will be loosened up, provided the thrust is most 
forcible which is applied to the lower extremity. 

This is a fairly good method to use in some cases, but 
we do not believe it is an effective way to loosen up 
articulations of the lumbar vertebrae, and falls far short 
of getting the results that we obtain by the rotary move- 
ment, and by the specific thrust when the spine is properly 
relaxed; for this reason this method is not accepted and 
used by spinal adjusters. 

6. Ilium Thrust Method. (See Illustration, page 
547.) — This method of procedure is an excellent way of 
affecting the articulations of the lower lumbar vertebra?, 
more especially the articulation of the fifth lumbar with 
the sacrum. 

We often find that one ilium is higher than its fellow. 
In such cases a thrust to the superior crest of the higher 
ilium and the force is directed downward. This will 
help materially in correcting an elevated condition of 
an innominate. Just before or after doing this, a 
thrust should be given to the trochanter of the femur 



Lumbar Methods. 



549 




Ilium thrust method Xo. 6. 



550 Spondylotherapy Methods. 

upon the opposite side, throwing the ilium in an upward 
direction. 

If we have drawn the heels together in a straight line 
with the body, in making an examination of a patient, 
we will often find that one limb will be half an inch, 
more or less, longer or shorter, than its fellow. A thrust 
to the crest of the ilium on the side of the shorter limb, 
throwing the innominate bond downward, while a thrust 
in the opposite direction on the side of the long limb, 
throwing the innominate bone upward, will often equalize 
the length of the limbs at once. A continuation of this 
practice for a sufficient time may balance up the limbs 
of the patient, which is no doubt due to simply changing 
the relation of the articulation of the fifth lumbar with 
the sacrum. 

We have also used this method of procedure success- 
fully in relieving interference with nerves of the lumbar 
region. Suppose, for example, that the nerve supply 
upon the right side of the lumbar is involved, causing 
pain, uneasiness or disease of the right extremity or the 
joints thereof. A rotary thrust on the crest of the left 
ilium, as the patient lies prone upon the treatment table, 
will open up the foramina upon the right side of the 
lumbar region, and relieve inteiference with the nerves. 

By this procedure we have been able to relieve some 
chronic cases of sciatic rheumatism. We believe, however, 
that the rotary method described above is much superior 
to this procedure in most cases. 

7. Spinal Swaying Method. (See Illustration, page 
515.) — This is a simple and effective procedure of relaxing 
and loosening up the musculature of the lumbar region. 
The technique of this operation is simple: 

Position. — The patient lies prone upon the adjust- 
ment table. 

The front section of the Bifed table should be so 



Lumbar Methods. 



551 



arranged that it will stand on its hind legs and rotate 
from side to side, as described under methods of thoracic 
adjustment, above. For a further description of this 
method, see the previous chapter. 



CHAPTER IX. 

METHODS OF ADJUSTMENT OF THE FIFTH 
LUMBAR VERTEBRA. 

METHODS of adjustment of the fifth lumbar 
vertebra are very important, and an under- 
standing of the best methods is very helpful 
for the reason that lesions of this vertebra, while they 
are rare, are most difficult to correct, especially when we 
try to do so by the old methods of adjustment, which 
Ave originally learned and used. We are glad now that 
we can describe, in a manner, some of the better meth- 
ods of fifth lumbar adjustment, and instead of using one 
method as we were taught, we teach and use half a dozen 
methods of procedure. 

The fifth lumbar is very apt to become subluxated, 
and for several reasons its relation to the sacrum is liable 
to become altered. 

1. Its shape. 

2. Its position. 

3. Superimposed weight. 

1. Its Shape. — The fifth lumbar is wedge-shaped, 
the posterior portion of its centrum being very thin 
compared with the anterior portion, which is much 
thicker. 

The shape of the centrum of the fifth lumbar vertebra 
accounts mostly for the abrupt turn or change of direc- 
tions of the anterior contour of the spinal column at the 
sacral prominence, which is situated at the sacro-lumbar 
junction of these spinal segments, and is called the sacral 
prominence. 

This wedge shape of the fifth lumbar renders it liable 
to a forward subluxation. Were it not locked very firmly 
bv the articular processes, there would be many more 

552 



Adjustment of Fifth Lumbar Vertebra. 553 

subluxations and luxations of this vertebra than we have. 
Also, the strong muscular attachments of the lower 
lumbar vertebrae and sacrum, is a protection against 
a forward movement of the fifth lumbar vertebra. 

Its Position. — The fifth lumbar, a movable vertebra, 
is articulated with the sacrum which is an immovable and 
solid segment of the spinal column. For this reason this 
articulation suffers more than any other articulation of 
the spinal column, being at the union of a solid and a 
movable segment of the spinal column. 

A person who may alight upon his feet from a fall, or 
in jumping off of an elevation, may suffer from a sub- 
luxation of the fifth lumbar because of the force of that 
fall, which will materially affect the tissues of the lumbo- 
sacral articulation. This is because of the fact that the 
long bones of the leg do not give or compress, but drive 
the innominate bones upward. The innominate bones, 
being firmly attached to the sacrum, the force of the fall 
will be felt very distinctly against the fifth lumbar or at 
the lumbo-sacral joint and less distinctly on each subse- 
quent articulation above. 

On the other hand, any weight on the shoulders, or 
any jars upon the upper extremities of the body, will 
spend their force particularly on the lumbo-sacral articu- 
lation. This is due to the physiological law, that when 
one end of an extended column is set in motion, that 
motion is transmitted to the other end. Any weight, 
force, or jar on the upper extremity, then, will spend its 
force on the lower end of the spine, or where the true, or 
movable vertebra articulates with the solid, or immov- 
able segment, the sacrum. 

Superimposed Weight. — The superimposed weight 
of the body bears more heavily on the vertebral segments 
of the spinal column as we pass downward. At the fifth 
thoracic segment, only that portion of the body above it 
tends to settle that portion of the spine. 



554 Spondylolherapy Methods. 

At the tenth thoracic vertebral segment a much 
larger portion of the weight of the body above, because 
of gravitation, brings pressure upon this region or segment. 

In case of the fifth lumbar vertebra the entire weight 
of the head and trunk of the body is supported by the 
lumbo-sacral articulation. This fact, connected with 
that of the shape of the fifth lumbar vertebra, will show 
plainly why there is a tendency to force the fifth lumbar 
vertebra anterior. 

Owing to the precautionary measures in the strength 
of the musculature spoken of above, this abnormal 
condition of the fifth lumbar is prevented in a great 
measure. We seldom in practice find cases in which the 
fifth lumbar is decidedly anterior. When we do find such 
cases, there is always material trouble with the nerve 
supply to the rectum and lower extremities, and we also 
find it is necessary to know and use suitable methods of 
procedure for the reduction of such lesions. 

In our first work on spinal adjustment, we knew of 
but one method of adjustment, and that was a very 
crude one. and inefficient. We call your attention to 
several effective methods of fifth lumbar adjustment 
which we enumerate under the following heads: 

1. Old method. 

2. Over a roll. 

3. Rotary method. 

4. Bohemian method. 

5. Sacral thrust method. 

6. Thumb thrust method, lying. 

7. Thumb thrust method, sitting. 

All of the above have been used, and are being used 
to-day by the most efficient practitioners of spinal 
adjustment. There are some of these methods that we 
favor, but we will describe all of them briefly for the sake 
of those who are progressive and those who would be 
resourceful. 



Adjustment of Fifth Lumbar Vertebra. 555 




Imperfect old method Xo. 1 



556 Spondylotherapy Methods. 

1. Old Method. (See Illustration, page 555.) — The 
old way of adjusting the fifth lumbar was by suspending 
the patient between the two sections of a Bifed ' table 
while he relaxed, or tried to, between the sections of the 
table. 

The ulnar border of the hand was then pressed in 
front of the sacrum, and a downward and forward thrust 
was given. This was the only method that we used for 
some time, but al] the time we used it we felt that it was 
unscientific, for the reason that if we did occasionally 
have a subluxation of the fifth lumbar, the tendency was 
for it to slip forward, hence a thrust that would drive it 
forward, would evidently only aggravate the trouble 
which existed. 

In our anxiety to break away from this unscientific 
form of adjustment, we contrived the method of adjust- 
ing over a roll. Others have devised the same expedient 
and probably for the same reason. 

2. Over a Roll. (See Illustration, page 557.) — In this 
method a roll of suitable size is placed under the pelvis 
as described in the previous chapter. This method 
separates the spinous processes of the lower lumbar 
vertebrae and enables us to apply a thrust to the spinous 
process of the one desired. For this reason we are able 
to get a point of contact back of the tip of the spinous 
process of the fourth or fifth lumbar with greater ease. 
A forward thrust should then be given and is much more 
effective because of the better contact we may obtain. 

This is quite an improvement over the method of 
supporting the patient between two sections of a table, 
because when they relax between the sections, the 
spinous processes of the lower lumbar vertebrae are so 
approximated that we cannot apply the thrust to them 
with any accuracy. 

This method, however, failed to solve the problem 



Adjustment of Fifth Lumbar Vertebra. 557 




Over a roll method. 



558 Spondylotherapy Methods. 

of what to do in case we had an anterior condition of 
the fifth lumbar vertebra relative to the sacrum. 

This condition, we are confident, can be corrected by 
different methods, and one method which we will next 
mention, which seems to correct, in a measure, this 
condition, is what we call the rotary method. 

3. Rotary Method. (See Illustration, page 543.)— 
This method has been described in the previous chapter, 
in which we discussed more fully the lumbar methods of 
adjustment. 

We will add, however, that if we desire to affect the 
articulation between the fifth lumbar and sacrum, we 
should do so by a suitable movement for that purpose. 

As the patient lies in position for the rotary lumbar 
method, and as the limb is used for the lever, the upper 
part of the trunk should be rotated from the operator, 
while the hips are rotated toward the operator by the 
hold on the knee. 

When the thrust is given, it should be given wholly 
with the lower extremity as a lever. The force should 
apply to the lower end of the spine, first and most. 

This method will loosen up the lumbo-sacral articu- 
lation with comparative ease and certainty, and will 
often give quick results in the way of relief of ailments 
of the lower extremity. 

We should observe the same rules as indicated above 
in Chapter VIII. on Lumbar Methods, namely: If the 
knee of the left leg is ailing, then use the right extremity 
as a lever for rotating for the relief of the fifth pair of 
lumbar nerves and the lame knee. 

4. Bohemian Method. (See Illustration, page 559.)— 
One of the best methods of adjustment of the fifth lumbar 
vertebra that we have learned is from the Bohemian 
system of spinal adjustment, and may be described as 
follows: 

Position. — According to the Bohemian way of giving 



Adjustment of Fifth Lumbar Vertebra. 559 




Bohemian fifth lumbar method. 



560 Spondylotherapy Methods. 

this adjustment the patient lies flat upon the back on 
the level floor. 

Arms are extended directly above the head, and feet 
and legs extended straight. 

The patient then raises the body up, retaining the 
arms directly overhead, and he continues to bend for- 
ward until he is flexed to the limit, with the hands still 
held up over the head. 

The operator applies a thrust to the top of the shoul- 
ders. The force of this thrust, according to the physio- 
logical law indicated above, travels to the lower end of 
the spine, and the force of it is spent upon the lumbo- 
sacral articulation. 

In America, often the patient's feet are too light 
to balance the patient; consequently it is necessary for 
the operator to bear down on the feet while the patient 
raises his body from the floor. There have been some 
modifications of this maneuver, one of which we often 
use, and it may be described as follows: 

The patient sits on the floor with the legs flexed at 
the knee, instead of remaining straight, as in the procedure 
described above. 

Then the hands are stretched above the head, and 
the body is thrown forward between the knees. This 
produces a very sharp angle at the lumbo-sacral articu- 
lation. 

A thrust is then applied to the top of the shoulders, 
the force of which is spent on the articulation between 
the sacrum and the fifth lumbar vertebra. 

Owing to the angle of the body, the tendency is to 
throw the fifth lumbar vertebra back and out, the same 
as is intended to be done in the other procedure, de- 
scribed above. 

We believe there is some advantage in folding the 
knees, for the reason that it seems that the body can be 
flexed more, and that the outward angle of the lumbo- 



Adjustment of Fifth Lumbar Vertebra. 561 

sacral union is thereby increased, and the more this 
angle is increased, the more will be the tendency to 
throw the fifth lumbar outward, as the result of a down- 
ward thrust and an upward resistance of the solid sacral 
segment against it. 

Still other modifications of this method have been 
made, but the above two methods we believe are the 
best, except in cases of children. The point to be watched 
in giving the above thrust to throw the fifth lumbar out, 
is as follows: 

If the spine is bent at a sharp angle anywhere above 
the lumbar region, there is a chance of the force of the 
thrust being spent at some other point than at the fifth 
lumbar, especially at any sharp angle. For this reason, 
certain precautionary measures should be taken when 
the back is too flexible. Raising the arm will tensify 
the muscles attached to the spinous processes of the 
vertebrae as follows: 

The trapezius connects with all the spinous processes 
of the thoracic region and supports them. 

The origin of the latissimus dorsi muscle is from the 
spinous processes of the lower thoracic and lumbar 
vertebrae, and supports them. 

The act of raising the arm will tense these muscles, 
and when they are tensed, it is almost impossible to 
cause any movement of any vertebra that is held by 
them. This will cause the force of the thrust to be spent 
on the last lumbar vertebra. 

Sometimes a patient will not reach up with enough 
force to tense these muscles sufficiently to prevent move- 
ment of the vertebrae at some angle of the spine above 
the lumbo-sacral articulation. This may be overcome 
in the following manner: 

The operator should stand to one side of the patient, 
and use the knee and that portion of the leg below it, to 
support the spinal column of the patient, as in Illustra- 



562 Spondylotherapy Methods. 

tion, page 559. In this way there is no probability of any 
movement of any vertebra or of any articulation of the 
spine above the fifth lumbar vertebra. 

5. Sacral Thrust Method. (See Illustration, page 
563.) — The sacral thrust method is a very useful one to 
use in making an adjustment of the fifth lumbar vertebra 
of small children. As their spines are very flexible, it 
is hard to regulate the force of the thrust which passes 
down the entire length of the spinal column. Therefore 
we seek for a more direct and closer contact with the 
articulation that we wish to affect. 

Position. — Lay the child on its back upon the adjust- 
ment table. 

Straighten the limbs and flex them over its abdomen. 
In so doing, you can flex the sacrum where it articulates 
with the fifth lumbar, causing an outward angle, beyond 
normal, in this portion of the spinal column. 

When the limbs are brought against the abdomen of 
the child, or nearly so, a thrust is given to the coccyx and 
sacrum at their lower end, which will open up the articu- 
lation between the sacrum and the fifth lumbar. 

The point of contact is so close to the place that we 
desire to adjust, that we can regulate this adjustment 
much better in the case of a child, than we can by using 
the method that we use on a larger person or an adult. 

6. Thumb Thrust Method, Lying. — As the patient 
lies upon the table, a lower extremity may be used as 
a lever, while the thumb is placed against the spinous 
process of the fifth lumbar vertebra. 

A side movement, which tends to open up the fifth 
lumbar articulation, may be made more specific and more 
efficient by a thrust of the thumb on the spinous process 
of the fifth lumbar vertebra, pressing it one way, while 
the legs are rotated in the opposite direction. 

This method has been described in connection with 
Lumbar Methods of Adjustment, in a previous chapter, 



Adjustment of Fifth Lumbar Vertebra. 563 




Sacral thrust method 5. 



564 Spondylotherapy Methods. 

and for that reason we give but a brief mention of it in 
this chapter. 

7. Thumb Thrust Method, Sitting. — This method 
of adjustment of the fifth lumbar has been described in 
the above chapter in connection with methods of adjust- 
ing lumbar vertebrae. 

It is applied in the same manner, and the body is 
rotated in the same way, but it requires a little more 
skill on the part of the operator to successfully loosen 
up the articulation of the fifth lumbar vertebra with 
the sacrum. This method is used by the osteopathic 
profession, and no doubt with success in a great many 
cases. We do not use it, because we are more familiar 
and more expert in the use of other methods. 

Most of the above methods that we have described, 
of adjustment of the different portions of the spinal 
column, are intended to be specific either with reference 
to a certain vertebra, or with reference to a certain region 
of the spine. We have methods that act generally upon 
the entire spine, and as a conclusion of this chapter we 
mention briefly some of the general methods of spinal 
treatment : 

Extensions. — Traction or extension causes a general 
stretching of the musculature of the spine, and a thicken- 
ing of the intervertebral tissues of the vertebrae. 

Stretching may be done by swaying with the head in 
the halter, while the feet are strapped to the floor. In 
this way a general tension may be brought to bear upon 
the entire length of the spinal column. After a sufficient 
length of time and frequent repetition of this treatment, 
there will be a decided lengthening of the spinal column, 
because of a general increase in thickness of the inter- 
vertebral discs. 

We also have stretching appliances in which the 
patient lies in the prone or dorsal position. The head 
and feet are both fastened. Tension is then made, while 



Adjustment of Fifth Lumbar Vertebra. 565 

the patient lies in comparative comfort. This tension 
is maintained or repeated until we have a permanent 
lengthening of the connective tissues and intervertebral 
tissues of the segments of the spinal column, 

In the above methods, either by stretching in the 
upright position, or in the longitudinal position, the 
entire spinal column is affected. 

If we desire to affect only the lumbar region and lower 
portion of the spinal column, we may do so by stretching 
from the arms, while the feet remain attached. Stretch- 
ing in this way brings a most direct action, it seems, on 
the lumbar segments of the spinal column. 

There is no doubt but what this stretching may be 
made more effective by continued and frequently repeated 
traction and relaxation. This may be done at almost any 
rate of speed if we have the proper apparatus. The 
increased traction and following relaxation may be 
repeated as often as 500 to 1,000 times per minute. 

We have a vibratory table made with a provision of 
this nature, in our office, which is very effectual in increas- 
ing the height of patients who are treated thereon, which 
it does by relaxation of the musculature and increasing 
the thickness of the intervertebral cartilages. 

For a detailed description of the effects and methods 
of spinal extension the reader is referred to Chapter I., 
Part Five. 



PART SIX. 

RAMIFICATION OF NERVES. 

CHAPTER I. 
CRANIAL NERVES. 

IN former chapters on the subject of nerve supply to 
the different organs and parts of the body, we have 
enumerated the principal nerves affecting, directly 
and indirectly, the viscera of the cavities of the head and 
thoracic, abdominal, and pelvic cavities collectively. 

In this chapter we wish to study the subject of nerve 
ramification, by considering each of the different viscera 
and the cerebro-spinal nerves, which supply each of 
them directly, and also those which affect them indirectly. 

We believe that by studying the nerve supply from 
two standpoints, namely: From the standpoint of the 
source of the nerve supply on the one hand, and the 
organs that are supplied by each pair of nerves, on the 
other hand, the student will gain a more comprehensive 
knowledge of the nerves and their relation to the organs 
they ramify and control. 

There is no subject that is of more interest to us in 
spinal treatment, than is the subject of nerve supply to 
the various organs. For this reason we believe there is 
ample cause for presenting the nervous system from 
different standpoints that this subject may be more 
comprehensible. 

One of our main reasons for presenting this subject 
in the way we do in this and in the following chapters, 
is that often we may detect nerves which are tender at 
their spinal exit, and it is necessary to have a compre- 
hensive knowledge of the organs principally supplied by 
the nerve which is involved. This is necessary that we 

567 




Raimficatioii of nerves. 



Cranial Nerves. 569 

may determine which organ is not functioning normally. 
This knowledge materially assists in both direct and 
differential diagnosis. 

A competent knowledge of this subject is one of our 
greatest helps in differential diagnosis; especially is this 
true when there is a question as to which organ or internal 
viscus is involved in any pathological process. 

Often organs which are adjacent receive their nerve 
supply from different segments of the spinal cord which 
are separated often by more or less space. 

We will not be enabled to give a thorough and com- 
plete outline of the ramification of all the different nerves, 
as that would require considerable time and space, but 
we hope to give sufficient information concerning this 
subject to enable a person when detecting a nerve that 
is interfered with, to know which organ it most directly 
ramifies and supplies, and consequently involves. On 
the other hand, we hope to enable one to trace a nerve 
from a pathological lesion back to the spinal origin of 
the nerve which directly and indirectly supplies the 
organ involved and is responsible for the deranged 
function. 

We will consider briefly the distribution and ramifi- 
cation of all the cranial and spinal nerves from the first 
cranial pair down to and including the fifth pair of lumbar 
nerves. We will first give attention to the ramification 
of the cranial nerves, and especially to the communicating 
branches of the spinal nerves which join them and exert 
an influence or materially affect their action. 

We will pay but little attention to the sacral and 
coccygeal nerves, for the reason that they cannot be 
interfered with at their exit from the neural canal, because 
they pass through foramina formed of solid and immovable 
segments of bone, and because of the further fact that 
they cannot be interfered with except through inter- 
ference with the dorsal or lumbar nerves which join them. 



570 Ramification of Nerves. 

In this connection we wish to take up first a general 
consideration of the twelve pairs of cranial nerves from 
the standpoint more especially of the anastamotic 
branches which affect their functional activity. 

We do not attribute so much importance to a study 
of the twelve pairs of cranial nerves from the standpoint 
of their origin, distribution and functional activity, as 
to a consideration of the functional control of these 
nerves by the communicating" branches affecting them 
which are from the upper "cervical and thoracic regions. 

We have frequently demonstrated, in our clinical 
experience, that lesions of the spinal column in the 
cervical and in the thoracic regions, which interfere with 
the integrity of these spinal nerves, interfere also with 
the normal functioning of the cranial nerves which they 
join. 

The fact that we have been able to restore hearing 
to the deaf, sight to the blind, and also to restore the 
function of taste and smell to those who have lost these 
functions, by relieving interference with the integrity of 
the upper cervical and thoracic nerves, proves conclu- 
sively that the functional activity of the cranial nerves 
is influenced and controlled by the communicating 
branches which they receive from these spinal nerves. 

It is for the above reasons we wish to call the reader's 
especial attention to the communicating branches from 
the spinal nerves which join and affect the integrity of 
the cranial nerves. 

There are many who know from experience which 
they have gained by correcting spinal lesions affecting 
the upper cervical and upper thoracic nerves, that such 
lesions do materially affect the functional action of the 
cranial nerves. 

There has been a very indefinite idea extant as to 
the connection existing or the way in which the com- 



Cranial Nerves. 571 

municating branches reach the cranial nerves and control 
their functional phenomena. 

This subject is not brought out definitely in our 
works on anatomy and physiology. But we wish to 
summarize the little that has been developed, discovered 
and written on this most important subject in a brief 
and comprehensive manner in this work. 



OLFACTORY NERVES. 

'^pHE first pair of cranial nerves, or olfactory nerves, 
^ are responsible for the afferent function of smell, 
and disease or any lesions that affect the integrity of 
the function of these nerves cause a disease known as 
anosmia. 

The olfactory nerves originate in three roots, the 
deep origin of which is as follows: 

The first root is from the corpus striatum, superficial 
fibers of the optic thalamus and form convolutions of 
the Island of Reil. 

The second root is from caruncula mammillaris and 
is connected by white fibers with the corpus striatum. 

The third root is made up principally of longitudinal 
fibers of the gyrus fornicatus. 

The superficial origin of the roots of the olfactory 
nerves is from the fissure of sylvius and the middle 
lobe of the cerebrum. 

The second middle root is from the gray matter of 
the anterior lobe of the cerebrum. 

The internal root consists of short white fibers which 
constitute the short root of this nerve, and comes from 
the inner part of the anterior lobe of gyrus fornicatus. 

The exit of the olfactory nerves after their three 
roots have united is by way of the foramina of the cribi- 
form plates of the ethmoid bones. 



572 Ramification of Nerves. 

The olfactory nerve terminates in the mucous mem- 
brane of the nose and divides into some twenty branches. 

The function of the olfactory nerves is that of smell. 
The integrity of the function of the olfactory nerves, 
though, depends upon the communicating branches 
which this pair of nerves receive from the upper cervical 
and upper thoracic nerves. 

The connection of the cervical and also the upper 
thoracic nerves with the olfactory nerve is not clear, but 
the fact that such a connection does exist is clearly 
proven by the fact that we are enabled to restore the 
sense of smell to people who lose it, by relieving and 
removing the lesions that interfere with the integrity of 
the cervical and thoracic nerves which contribute com- 
municating branches to the olfactory nerves. 

We have restored the power of smell to patients who 
had suffered with complete anosmia several years, and 
have repeatedly done so by removing all spinal lesions 
interfering with the integrity of the spinal nerves which 
send communicating branches to the olfactory nerves. 

The connection no doubt is made by way of the 
internal carotid plexuses of the sympathetic system. 

Especially is this true of the connection between the 
superior thoracic nerves and the olfactory nerves. 

The white rami of the upper thoracic nerves which 
join and help to form the upper stream of white rami 
communicantes all terminate in the superior cervical 
ganglia of the gangliated cords. The superior cervical 
ganglia, however, and the internal carotid plexuses which 
are just above them, are a continuation of the gangliated 
cords of the sympathetic. The superior cervical ganglia 
and the internal carotid plexuses jointly connect with 
all of the twelve pairs of cranial nerves. 

Spinal impulses are carried by way of gray rami after 
they pass the superior cervical ganglia on the different 
cranial nerves. 



Cranial Nerves. 573 

The physiological impulses of spinal origin are trans- 
mitted to the olfactory nerves and they are directly 
responsible for their excitability and conductivity and 
their functional phenomena. 

The communicating branches of the cervical nerves do 
not join the cervical ganglia of the sympathetic system, 
and do not in this way reach and communicate with the 
crania] nerves. They send their communicating branches 
into the terminal ganglia which are in relation with the 
cranial nerves and in this way communicate with them, 
and control their function. 

The upper cervical nerves are no doubt responsible 
for the function of smell of the olfactory nerves to by far 
the greater extent; while the remainder of the activity 
of the olfactory nerves seems to be due to the communi- 
cating rami of the upper thoracic nerves through the 
upward stream of white rami communicantes and the 
superior cervical ganglia and internal carotid plexuses. 
The upper cervical nerves connect with the olfactory 
nerves by first joining the terminal ganglia. 

OPTIC NERVE. 

'TTHE second pair of cranial nerves, or the optic nerves, 
■^ are responsible for the power of vision, hence it is 
important that we understand the spinal connection of 
the nerves of the cervical and thoracic regions communi- 
cating with and controlling the function of the optic 
pair of nerves. 

The optic nerves, strictly speaking, do not appear to 
be nerves in the ordinary sense. They seem to possess 
the power of the afferent transmission of the vibrations 
of light, back to the optical centers of the occipital lobe. 
This power, however, depends upon the integrity of the 
communicating branches from the cervical and thoracic 
nerves. 



574 Ramification of Nerves. 

ORIGIN. 

/ ~PHE deep origin of the optic nerves is from the cortical 
■^ portion of the occipital lobe, coming directly from 
the optic thalami, corpora geniculata, and corpora 
quadrigemina. 

They pass from the brain through the optic commis- 
sure along the optic tract by two bands. Their exit from 
the cranium is through the optic foramina. 

Their distribution is principally to the retina which 
they by division and expansion supply with numerous 
branches of ramification. 

They first pierce the sclerotic and choroid coats at 
the back of the eyeballs, a little to the nasal side of the 
center, and then extend into and throughout the surface 
of the retina. The optic nerve function is that of vision. 
Disease of the optic nerve causes optic neuritis and 
general visual disturbance. 

The upper thoracic nerves affect the optic nerves by 
way of the superior streams of the white rami communi- 
cantes and by means of the gray rami from the superior 
cervical ganglia which join the second pair of cranial 
nerves. 

The superior cervical nerves send branches directly 
into the terminal ganglia affecting the optic pair of nerves. 
The terminal ganglia affecting optic nerves is the optic 
or ophthalmic ganglia of the sympathetic system. 

The function of vision seems to be almost wholly due 
to the integrity of the upper cervical and upper thoracic 
nerves for the reason they send communicating branches 
directly and indirectly to the second pair of cranial nerves. 

There is positive evidence of the influence of cervical 
and spinal nerves upon the power of vision of the optic 
nerves which is manifest when relieving interference with 
them. 

We call attention to our clinical experience' in which 



Cranial Nerves.. 575 

we have been enabled to restore sight to eyes that were 
blind. We have been able to restore sight to eyes that 
were absolutely blind, in from three to four hours after 
adjustment, when the blindness was of recent origin. In 
cases that have been blind as long as from five to ten 
years we have been able to restore the power of vision in 
one week's time. Now we have restored the vision 
wholly by removing spinal lesions that interfered with 
the integrity of the nerves which send communicating 
branches to the optic nerve. These facts prove conclu- 
sively that optic nerve function is dependent upon the 
communicating branches which connect with it, from the 
spinal nerves. 

This fact opens up a new field of thought to our 
physiologists and anatomists — one that is worthy of 
note, study and investigation — and we hope that much 
more light will be thrown upon this subject by future 
study and by subsequent investigation. 

MOTOR OCULI. 

'T*HE third pair of cranial nerves or motor oculi furnish 
• myomotor influences to the muscles of the eyeball. 
Diseases of this pair of nerves cause ptosis. 

The origin of the motor oculi is principally from the 
floor of the aqueduct of Sylvius, and they receive fibers 
from tbetubercula quadrigemina, valve of Vieussens, and 
their superficial origin is from the cms cerebri. 

The exit of this pair of nerves is through the anterior 
sphenoidal fissures. The distribution of the motor oculi 
is as follows: 

Superior division is to the superior rectus and levator 
palpebrae. 

Inferior division is to the inferior rectus, internal 
rectus, and inferior oblique. 

From the inferior oblique is a thick, short branch sent 



576 Ramification of Nerves. 

to the lower border of the lenticular ganglion and it is 
supposed to be a motor root. 

The function of this pair of nerves is myomotor. The 
oculi motor nerves rise by several roots which join and 
form one trunk. The common nerve trunk thus foimed 
runs forward and slightly outward and is distributed to 
the dura mater near the posterior clinoid process and 
enters the cavernous sinus. It runs below the wall of 
the sinus and above and to the outer side of the internal 
carotid artery, and in this way it enters the sphenoidal 
fissure. 

In this fissure it lies to the inner side of the abducens 
nerve in the angle formed by the tendinous origins of the 
internal and external rectus muscles. After passing into 
the orbit it divides between the two heads of the external 
rectus into two terminal branches, the smaller superior 
and the larger inferior division. 

In the passage of the motor oculi nerve through the 
cavernous sinus and the sphenoidal fissure, they receive 
fibers from the sympathetic plexus which surrounds the 
internal carotid artery or the internal carotid ganglia of 
gangliated cords, and also receive a branch of communi- 
cation from the ophthalmic division of the fifth pair of 
cranial nerves. 

The superior division of the motor oculi runs along 
the outer side of the optic nerve and passes upward and 
ends by splitting into two branches, one branch supply- 
ing the superior rectus muscle of the eye, and the other 
branch supplies the levator palpebrae superioris. 

The inferior division also passes at first on the outside 
of the optic nerve, but soon passes downward and gives 
off three branches in its course: 

1 . A long branch to the rectus inferior. 

2. A short branch to the rectus internus. 

3. A shorter branch to the ciliary ganglia. 



Cranial Nerves. 577 

The inferior division gives off branches which termi- 
nate in the obliquus inferior. 

OPHTHALMIC GANGLIA. 

^T^HESE are small, flat, quadrilateral nodules, situated 
■* on the outer sides of the optic nerves; they are 
about one-third of an inch in front of the optic 
foramina. These ganglia are supposed to belong to the 
sympathetic division of the nervous system because they 
are composed of multiple cells of the sympathetic type. 

Three important roots enter into or join the ophthalmic 
ganglion: 

First, a branch from the inferior division of the motor 
oculi nerve. 

Second, several distinct fibers from the nasal nerve 
join the ganglia. 

Third, several fine filaments from the carotid plexus. 

Sometimes there is also an inferior middle root from 
Meckel's ganglion. 

The root from the motor oculi nerve is a little short 
root, while the one from the nasal nerve is a long root; 
the middle root is from the carotid plexus. 

From the anterior border of the ophthalmic ganglia 
emerge the short ciliary nerves. They are usually five 
to ten in number. They surround the optic nerve and 
run almost parallel with it toward the eyeballs. These 
five to ten branches of the two nerves are arranged into 
the superior and inferior, external and internal branches; 
before they reach the eyeball they divide again into 
from ten to fifteen filaments on each side. 

They then pass between the sclerotic and choroid 
coats to the ciliary bodies of the eye. These branches 
form a plexus which ramifies the entire ciliary bodies. 
This ganglion contains ganglionic cells and fibers to 
several points which originate from this ganglia as follows : 



578 Ramification of Nerves. 

1. To the cornea. 

2. Fibers to the ciliary muscles. 

3. Fibers to the musculature of the iris. 

4. Fibers to the vessels of the lachrymal glands. 

5. Fibers which end between the muscles of the 

ciliary bodies. 

From the above we see how nerves which send com- 
municating branches to the ophthalmic ganglia may 
influence the functions of the cornea, the ciliary muscles, 
lachrymal apparatus and the ciliary bodies. 

The nerves which send branches into and join the 
ophthalmic ganglia are from the upper thoracic and 
upper cervical region. 

The anatomical parts supplied by the ophthalmic 
ganglia may receive impulses through this ganglia or 
from the superior cervical nerves by direct branches of 
ramification which join these ganglia. If from the su- 
perior thoracic nerves, then the impulses are by way 
of the white rami communicantes to the superior 
cervical ganglion and then through the internal carotid 
plexus to the ophthalmic ganglion. We have often 
been able to restore the power of compensation to 
the muscles of the eye and to correct refractive errors by 
removing spinal lesions that interfered with the integ- 
rity of the nerves which send communicating branches 
to the ophthalmic ganglia. 

We hope to see a more thorough investigation along 
this line, which may be done in a clinical way by carefully 
testing the refractive errors of the eyes of cases treated, 
both before and after treatment. 



CHAPTER II. 
CRANIAL NERVES. 

THE trochlear or fourth pair of cranial nerves are 
sometimes called the pathetic nerves. 

Then deep origin is from the upper part of the 
valve of Vieussens immediately behind the testes. 

Then superficial origin is from around the outer side 
of eras cerebri. 

Then spinal exit is by way of the sphenoidal fissure, 
and these nerves occupy the highest position in the 
sphenoidal exit. 

The pathetic nerves are distributed to the superior 
oblique muscles of the eye; they are the smallest pair of 
cranial nerves. 

They also give off a recurrent branch to the tentorium 
cerebelli. This branch divides into three or four filaments 
and may be traced as far back as the Avails of the lateral 
sinus in then passage from their origin. 

Their superficial origin is from the outer side of the 
eras cerebri. They are first directed outward but they 
soon change to an inward and forward direction and wind 
round the eras cerebri and thus pass to and lie on the 
outer side of the optic nerves, and occupy a position 
between them and the abducens nerves. 

They pierce the dura mater just outside of the posterior 
clinoid processes and near the attachment of the ten- 
torium cerebelli. 

They pass in a canal formed by the dura mater or 
along the superior angle of the cavernous sinus; in their 
further course upward they accompany the frontal and 
lachrymal nerves. They make their exit through the 
upper and outer parts of the sphenoidal fissures, then 
they ramify the superior oblique muscles. 



580 Ramification of Nerves. 

This pair of nerves in their course extending along 
the cavernous sinuses receive communicating fibers from 
the sympathetic plexus which are formed around the 
internal carotid arteries. 

They also receive communicating branches from the 
ophthalmic division of the fifth pair of cranial nerves. 
White rami communicantes from the upper thoracic 
nerves, which join the superior cervical ganglia, send 
impulses to the trochlear nerves by way of the internal 
carotid plexus of the gangliated cords of the sympathetic. 

Impulses from the cervical spinal nerves are carried 
to the trochlear nerves by way of branches joining the 
trifacial nerves and the terminal sympathetic ganglia. 

TRIGEMINAL NERVES. 

'T^HE trigeminal or trifacial nerves are the fifth pair 
A- of cranial nerves. They divide into three im- 
portant divisions: 

I. The Ophthalmic. 
II. Superior Maxillary. 
III. Inferior Maxillary. 

I. THE OPHTHALMIC DIVISION. 

T^HE ophthalmic division arises in its deep origin 
*■ from the lateral tract of the medulla oblongata. 
It divides into two roots and runs forward and 
enters the cavernous sinus and lies below the trochlear 
nerve, and external to the abducens nerve and separates 
it from the internal carotid artery. 

In the sphenoidal fissure it divides into three terminal 
branches. It receives communicating branches from the 
internal carotid plexus and gives off fibers to the three 
nerves which enter with it into the muscles of the eye. 
I. Nasal nerve. 
II. Frontal nerve. 



Cranial Nerves. 581 

III. Lachrymal nerve. 

IV. Nervus tentorii. 

I. Nasal Nerve. — This branch of the nerve passes 
through the middle portion of the sphenoidal fissure, 
between the two bands or heads of the rectus externus 
muscle, and lies on the outer side of the abducens and 
motor-oculi nerves. 

It then passes forward and inward in an oblique 
direction and crosses the optic nerve. It then passes to 
the inner surface of the superior oblique muscle, where 
it divides. 

The branches of the nasal nerves are as follows: 

1. Long ciliary nerve. 

2. Infra- trochlear nerve. 

3. Anterior ethmoidal nerve. 

4. Long root of ciliary ganglia. 

1. Long Ciliary Nerve. — This nerve consists of from 
two to four slender filaments, which join the short ciliary 
nerves from the ciliary ganglion, and together they enter 
the back of the eyeball. 

2. Infra-trochlear Nerve. — This nerve passes along 
the outer inferior border of the obliquas superior, until 
it divides into the inferior and superior palpebral branches. 

The superior branch supplies the inner can thus, the 
eyelid and the eyebrow. 

The inferior branch supplies the lachrymal sac, con- 
junctiva, lower eyelid, and gives branches to the root of 
the nose. 

3. Anterior Ethmoidal Nerve. — This nerve is a 
continuation of the nasal nerve; its cranial exit is the 
anterior ethmoidal foramen. It passes through the 
cribiform plate of the ethmoid bone and thus reaches 
the nasal cavity; in the nasal cavity this nerve divides 
into three branches: 

(a) Internal nasal branches ramifying the anterior 
portion of the nasal septum. 



582 Ramification of Nerves. 

(b) Anterior nasal branches ramifying the anterior 
portion of the lateral wall. 

(c) External nasal branch; this is the largest branch 
and is a continuation of the anterior ethmoidal; this 
nerve ramifies and supplies the skin over the root and 
dorsum of the nose. 

II. The Frontal Nerve. — The frontal nerve in its 
passage lies between the lachrymal and trochlear nerves, 
its cranial exit into the orbit is through the sphenoidal 
fissure. The frontal nerve passes forward; along the 
roof of the orbit it divides into three branches back of 
the eye and ramifies the levator palpebrse superioris. 

The frontal nerve divides into three branches, as 
follows : 

1. Frontal branch. 

2. Supra-orbital nerve. 

3. Supra- trochlear nerve. 

1. The Frontal Branch. — This nerve supplies the 
internal parts of the forehead and anastomoses quite 
freely with the supra-orbital nerve. 

2. The Supra-orbital Nerve. — This nerve passes 
in company with the supra-orbital artery through the 
supra-orbital foramen, and after piercing the orbicularis 
oculi muscle, it supplies the skin of the frontal region. 

3. Supra-trochlear Nerve. — This is the smallest 
branch of the frontal nerve. This nerve passes out of 
the orbital cavity and supplies the skin and conjunctiva 
near the inner canthus. This nerve in its passage receives 
and gives off communicating branches to the infra- 
trochlear nerve 

III. Lachrymal Nerve. — The lachrymal nerve is 
another division of the ophthalmic division of the tri- 
facial nerve. While passing through the orbit it runs 
along its roof, and along the upper border of the external 
rectus muscle in company with the lachrymal artery. It 
divides up into numerous branches which enter the 



Cranial Nerves. 583 

lachrymal gland. Some of these fibers supply parts of 
the gland and the secreting tubuli, while the other fibers 
pass through the gland and supply the skin and con- 
junctiva of the outer canthus. 

The lachrymal nerve in its passage gives off a com- 
municating branch to the zygomatic nerve before it 
enters the lachrymal gland. This branch runs downward 
and forward along the outer wall of the orbit. 

IV. Nervus Tentorii. — This branch runs backward 
in close apposition to the trochlear nerve. In its passage 
it receives communicating branches from the sympa- 
thetic system by way of the internal carotid plexus. 

The nervus tentorii supply the: 

1. Tentorium. 

2. Rectus sinus. 

3. Petrosal sinus. 

4. Transverse sinus. 

II. SUPERIOR MAXILLARY DIVISION. 

/ I A HE superior maxillary division of the trifacial or 
* trigeminal nerve is larger than the ophthalmic 
division. This division of the trifacial nerve arises from 
the gray nucleus at the back part of the medulla, between 
the fasciculatus teretes and restiform columns, and the 
floor of the fourth ventricle. * 

This division passes through the superior maxillary 
bone by the foramen rotundum, from the skull cavity. 

The superior maxillary division gives off the following 
branches : 

1. Zygomatic nerve. 

2. Spheno-palatine nerve. 

3. Superior dental nerve. 

4. Middle meningeal nerve. 

5. External nasal branches. 

6. Superior labial branches. 

7. Inferior palpebral branches. 



584 Ramification of Nerves. 

1. The Zygomatic Nerve passes through the spheno- 
maxillary fissure, along the outer wall of the orbit. It 
divides into the two following branches: 

(a) Temporo-malar branch. 

(b) Temporo-facial branch. 

(a) The temporo-malar branch ramifies and supplies 
the skin of the temporal region and of the outer part of 
the frontal region. 

(b) The temporo-facial branch ramifies and supplies 
the skin of the cheek and of the lower eyelid. 

2. Spheno-palatine Nerves consist of two or three 
stout filaments which are given off in the pterygo- 
palatine fossa, which enter into the formation of a 
spheno-palatine ganglion. 

3. Superior Dental Nerves consist of four or five 
filaments that are given off while they are passing through 
the infra-orbital canal. 

The superior dental nerve divides into three branches, 
as follows: 

(a) Middle superior dental nerve. 

(b) Anterior superior dental nerves. 

(c) Posterior superior dental nerves. 

(a) The middle superior dental nerve is given off 
in the infra-orbital canal and joins the superior dental 
plexus. 

(b) The anterior superior dental nerve leaves the 
main trunk before it emerges from the infra-orbital canal. 
This nerve also enters into the formation of a superior 
dental plexus. It also gives off a nasal branch which goes 
to the vestibulum nasi. 

(c) The posterior superior dental nerve consists of 
two or three branches which are given off from the main 
trunk just as it enters the canal. 

They supply the buccal mucous membrane and the 
last molar teeth of the upper jaw and the posterior or 



Cranial Nerves. 585 

alveolar foramina. Like the other branches they join 
into the formation of the superior dental plexus. 

Branches of this nerve ramify and supply the gums 
and the teeth and are known as the rami dentales supe- 
riores; and also send fibers to the mucous membrane 
and lining of the antrum. 

4. Middle Meningeal Nerve. — The middle men- 
ingeal nerve accompanies the middle meningeal artery 
and ramifies and supplies the dura mater. 

5. External Nasal Branches. — These branches are 
all distributed to the alae nasi. 

6 . Superior Labial Branches. — These branches con- 
sist of three or four large nerves which supply the skin 
and mucous membrane of the upper lip. 

7. Inferior Palpebral Branches. — These nerves 
represent the external nasal branches and the superior 
labial branches, and branches of the infra-orbital nerve. 
They ramify the skin of the lower eyelid and communicate 
with the facial and infra-orbital nerve and plexus. 

SPHENO-PALATINE GANGLION. 

(Meckel's Ganglion.) 

/ T V HIS ganglion is a minute, flat, triangular or quadri- 
■*■ lateral ganglion, situated in the ptery go-palatine 
fossa. They are situated internally and somewhat 
below the superior maxillary division. This ganglion is 
evidently of the sympathetic system, as is determined 
by its microscopical appearance. This ganglion has 
three important roots: 

1. A motor. 

2. A sensory. 

3. A sympathetic. 

The motor root received by this ganglion is from the 
great superficial petrosal nerve. 

The sensory root received by this ganglion is from the 
spheno-palatine nerve. 



586 Ramification of Nerves. 

The sympathetic root received by this ganglion is 
from the great deep petrosal nerve. 

The spheno-palatine or Meckel's ganglion gives off a 
number of branches which supply the mucous membrane 
of the heart and soft palate and nose. Most of these 
fibers are sensory in function. 

The branches of Meckel's ganglion are as follows: 

1. Orbital branches 

2. Naso-palatine nerve. 

3. Middle palatine nerve. 

4. Anterior palatine nerve. 

5. Posterior palatine nerve. 

6. Posterio-inferior nasal branches. 

7. Posterio-superior nasal branches (external). 

1. The Orbital Branches supply the spheno-maxil- 
lary fissure, the ethmoidal cells, and the sphenoidal sinus. 

2. Naso-palatine Nerve.— This nerve, together with 
the naso-palatine artery, supplies the nasal septum and 
the mucous membrane of that region. 

3. Middle Palatine Nerve. — This nerve supplies 
the soft palate with sensation and also the azygos uvulae 
and the levator palati muscles with motor fibers. 

4. Anterior Palatine Nerve. — This nerve, together 
with the middle and posterior palatine nerves, passes 
through the ptergo-palatine canal. It supplies sensory 
nerve filaments to the hard palate. It gives off branches 
of communication to the naso-palatine nerve. 

5. Posterior Palatine Nerve. — This nerve has a 
similar course to the middle palatine through the foramen 
and supplies the outer portion of the palate and the 
tonsil. 

6. Posterio-inferior Nasal Branches. — They sup- 
ply the middle and inferior turbinated bones and give a 
branch to the superior dental plexus. 

7. Posterior-superior Nasal Branches. The 
external one consists of from five to seven filaments and 



Cranial Nerves, 587 

supplies the posterior ethmoidal cells and the superior 
and middle turbinated bones. It also gives branches to 
the pharyngeal mucous membrane. 

The internal branches of the above group supply the 
mucous membrane of the septum of the nose. 

III. INFERIOR MAXILLARY DIVISION. 

'T^HIS constitutes the third division of the trifacial 
1 nerve. It is known sometimes as the mandibular 
division. This nerve is formed by the motor root from 
the trigeminus, and by branches from the gasserian 
ganglion of the sympathetic. 

The inferior maxillary nerve receives two or three 
communicating filaments from the otic ganglion. The 
branches of the superior maxillary division are as follows: 

1. Spinal branch. 

2. Lingual nerve. 

3. Masticatorious nerve. 

4. Auriculo-temporal nerve. 

5. The inferior dental nerve. 

These branches give off branches as follows: 
The lingual nerve gives off five branches: 

1. Lingual branches. 

2. Sublingual branches. 

3. Rami sithmi faucium. 

4. Two filaments to the submaxillary ganglion. 

5. Anastomatic branches to the hypoglossal nerve. 
The masticatorious nerve gives off the following 

branches : 

1. Long buccal nerve. 

2. Nerve to Masseter. 

3. Deep temporal nerves. 

4. Nerves to internal pterygoid. 

The auriculo-temporal nerve gives off the following 
branches: 



** 



588 Ramification of Nerves. 

1. Parotic branches. 

2. Anterior auricular branches. 

3. Superficial temporal branches. 

4. Branches to external auditory meatus. 

5. Communicating branches to the facial nerve. 

Inferior Dental Nerve. — 

The inferior dental nerve is the largest branch of the 
inferior maxillary division. It splits up into terminal 
branches as follows: 

1. Mental nerve. 

2. Nerve to mylohyoid. 

3. Inferior gingival branches. 

4. Anterior inferior dental branches. 

5. Posterior inferior dental branches. 

The names of these nerves indicate clearly the part 
they supply. 

The Sub-maxillary Ganglion. — 

This ganglion is situated under the mucous membrane 
of the floor of the mouth, and between the lingual nerve 
and the sub-maxillary gland. This is a sympathetic 
ganglion, as is determined by microscopical examination. 

It receives branches as follows: Two roots from the 
lingual nerve, third root from the sympathetic plexus 
maxillaris externus. 

Otic Ganglion. — 

This is a small oval ganglion situated just below the 
foramen ovale. This is probably also a sympathetic 
ganglion. Its roots are the filaments which join it to the 
trigeminal, facial, glosso-pharyngeal and sympathetic 
nerves. 

Communicating branches are received from the 
following: 

1. Superficial petrosal nerve. 

2. Communicating with meningeal plexus. 

3. Communicating with inferior maxillary division. 



Cranial Nerves. 589 

The first set above, the small superficial petrosal nerve, 
comes from the tympanic plexus which lies under the 
mucous membrane of the promontory of the tympanic 
cavity. It enters the skull cavities through the superior 
aperture of the tympanic canal, and receives branches 
from the geniculate ganglion of the facial nerve. It 
leaves the cranial cavities through a small foramen 
situated between the foramen ovale and foramen and 
enters the otic ganglion. 

From the sympathetic ganglion, or plexus that sur- 
rounds the middle meningeal artery, several communi- 
cating branches are given to the otic ganglion. These 
constitute the communicating branches with the men- 
ingeal plexus. 

The internal pterygoid nerve gives off two or three 
filaments which join the otic ganglion and form what is 
known as the communicating branches with the internal 
inferior maxillary division. 

The Communicating Branches of the Otic Ganglion 
of the Motor Nerve. — 

These branches may be enumerated as follows: 

1. Small superficial petrosal nerve. 

2. Anastomotic with cordi tympani. 

3. Anastomotic with meningeal plexus. 

4. Anastomotic branch with meningeal branch. 

5. Anastomotic branch to the auriculo temporal nerve. 

6. Anastomotic branch with inferior maxillary divi- 

sion. 



CHAPTER III. 
CRANIAL NERVES. 

THE sixth pair of cranial nerves are called the abducen 
nerves, or the external oculo-motor nerves. They 
arise from the floor of the fourth ventricle, and 
their superficial origin is from the lower border of the 
pons varolii. They make their exit from the cranial 
cavity through the sphenoidal fissure, between the heads 
of the external rectus muscles, they supply the external 
rectus motor muscle of the eye. 

As one of these nerves passes to lie between the 
internal carotid artery and the ophthalmic division of 
the fifth nerve it receives two or three filaments from the 
carotid plexus. After the nerve enters the sphenoidal 
fissure above the superior ophthalmic vein it receives 
communicating branches from the ophthalmic division 
of the fifth nerve. 

Facial Nerves. — The facial or the seventh pair of 
cranial nerves rise from the floor of the fourth ventricle. 
Their superficial origin is from below the margin of pons 
varolii, lateral tract of the medulla oblongata and from 
the groove between the olivary and restiform bodies. 
They make their exit from the cranial cavity through the 
stylo-mastoid foramina. The facial nerves are the chief 
motor nerves of the face and head. They supply all the 
muscles of expression as follows: 

1. Stapedius, 

2. Stylohyoid, 

3. Levator palati, 

4. Azygos uvulae, 

5. Occipito frontalis, 

and send branches to the spheno-palatine ganglion. The 

590 



Cranial Nerves. 591 

facial nerves also contain motor and secretory fibers 
which enter into the geniculate ganglion. 

The facial nerves have a number of connections with 
the sensory fibers of the trigeminal, pneumogastric and 
glosso-pharyngeal nerves. 

The facial nerves divide into two important divisions, 
one is the upper facial division and the other is the 
cervico-facial division. 

The principal branches of the temporo-facial division 
are: 

1. Molar. 

2. Temporal. 

3. Infra-orbital. 

The cervico-facial branch divides into three divisions: 

1. Superior maxillary. 

2. Inferior maxillary. 

3. Cervical branches. 

The branches given off by the facial nerves might be 
enumerated as follows: 

1. Corda-tympani, 

2. Buccal branches, 

3. Temporal branches, 

4. Cervical branches, 

5. Zygomatic branches, 

6. Nerve to stapedius, 

7. Branch to digastric, 

8. Mandibular branches, 

9. Branch to stylohyoid, 
10. Posterior auricular nerve, 

and have communicating branches to the auricular 
branch or vagus. 

The names of the branches of the nerves given above 
will indicate the parts they supply. In this connection 
we wish to consider briefly the geniculate ganglion. This 
is a ganglion composed of unipolar cells that are similar 
to the cells of a spinal ganglia. Situated on the end of 



592 Ramification of Nerves. 

the horizontal portion of the facial nerve, this geniculate 
ganglion gives off two important nerves : 

1. The communicating branch to the tympanic plexus. 

2. Two great superficial petrosal nerves to Meckel's 

ganglion. 

Auditory Nerve. — Auditory or acoustic nerves are 
the eighth pair of cranial nerves. They originate prin- 
cipally from the anterior walls of the floors of the fourth 
ventricles. Their superficial origin is from around the 
restiform bodies. 

Exit. — The cranial exit of an acoustic nerve is through 
the meatus auditorius internus. 

Distribution. — The distribution of the eighth pair 
of cranial nerves is through the following branches: 

1. Vestibular nerve. 

2. Cochlear nerve. 

The vestibular nerve lies within the internal auditory 
meatus in close apposition to the following, and divides, 
at the fundus of the meatus, into its terminal branches. 

Its branches are as follows: 

1. Uticulate nerve. 

2. Superior ampullary nerve. 

3. Inferior ampullary nerve. 

4. External ampullary nerve. 

The cochlear nerve divides into a number of filaments 
before entering the central canal. Several filaments 
form a plexus and the ganglion of Corti. This ganglion 
also has bipolar cells. 

The branches of the cochlear nerve are as follows: 

1. Sacular nerve. 

2. Trochlear nerve. 
Glosso-pharyngeal Nerves. — The glossopharyn- 
geal nerves are the ninth pair of cranial nerves. A 
glosso-pharyngeal nerve is a mixed nerve containing 
both afferent and efferent fibers. 

The deep origin of the glosso-pharyngeal nerve is 



Cranial Nerves. 593 

from the nucleus of gray matter situated at the lower 
part of the floor of the fourth ventricle, and external to 
the fasciculi teretes, the superficial exit from the crania] 
cavity or the nose. 

The superficial origin of the glosso-pharyngeal nerves 
is from the upper part of the medulla oblongata, just 
behind the olivary bodies. 

Exit. — The exit of the glosso-pharyngeal nerve is 
through the central part of the jugular foramen, and upon 
it are two ganglionic enlargements: the superior and the 
smaller; the inferior and the larger. 

The function that is supplied and controlled by 
this nerve is that of taste which nerve is supplied to 
the tongue. 

The branches of the glosso-pharyngeal may be enu- 
merated as follows: 

1. Carotid branches. 

2. Lingual branches. 

3. Muscular branches. 

4. Tympanic branches. 

5. Tonsillar branches. 

6. Pharyngeal branches. 

7. Stilo-pharyngeal branches. 
The ganglionic enlargements are: 

1. The ganglion superioris. 

2. The Petrous ganglion. 

Both of these ganglion are composed of unipolar cells, 
and they are considered true cerebro-spinal ganglion. 

The names of the branches of the pharyngeal nerves 
sufficiently indicate the parts that they supply. 

We might mention in this connection, however, that 
the tympanic nerve divides up into three branches: 

1. Twigs of the tympanic to mucous membrane. 

2. Small superficial petrosal nerves to otic ganglion. 

3. A branch to the mucous membrane of the eusta- 

chian tube. 



594 Ramification of Nerves. 

Vagus Nerves. — The vagus or tenth pair of cranial 
nerves are also known as the pneumogastrie nerves. 
These nerves are mixed, containing both afferent and 
efferent fibers, and also receive communicating branches 
from the sympathetic. 

The pneumogastrie nerves are the principal motor 
nerves to the stomach, lungs, esophagus, heart, and all 
the viscera of the thoracic, abdominal and pelvic cavity. 
They convey fibers which supply and regulate the move- 
ments of the heart, bowels, and other viscera of the 
trunk. 

These nerves are supposed to furnish the secretory 
impulses to the stomach and also to the kidneys. 

The pneumogastrie nerves have their deep origin 
from the floors of the fourth ventricles. 

The superficial origin of the pneumogastrie nerves 
are from a number of filaments from the lateral tracts 
of the medulla oblongata behind the olivary bodies 
below the origin of the glosso-pharyngeal nerves. Their 
superficial origins are by the same sheaths as the spinal 
accessory nerves through the jugular foramina. 

There are two ganglion given off from each of these 
two pair of nerves: 

1. Superior jugular ganglion or ganglion of the root 

of pneumogastrie. 

2. Inferior jugular ganglion or ganglion of trunk of 

the pneumogastrie. 

The Jugular Ganglion. — This is a small ganglia 
composed, like the ganglion nordosum, of unipolar cells 
of the posterior root and of the ganglionic type. 

This ganglion receives communicating branches from 
the superior cervical ganglion of the sympathetic, and 
sends a twig to the spinal accessory nerve, and also has 
other branches: 

1. Auricular branches. 

2. Meningeal branches. 



Cranial Nerves. 595 

1. The auricular branches pass along the anterior 
surface to the mastoid canal. They cross the facial nerve 
and appear just behind the styloid foramen. A lower 
branch of each joins the posterior auricular branch of 
the facial nerve, while an upper branch ramifies the 
posterior surface of the external auditory meatus. These 
nerves thus communicate, as already described, with the 
facial nerve, and glosso-pharyngeal. 

Ganglion Nordosum. — This is much larger than the 
jugular, about an inch long and one-fifth of an inch broad. 
This ganglion lies behind the internal carotid artery, 
and in front of the superior cervical ganglion. By 
slender filaments it is connected with the superior cervical 
ganglion, and with the hypoglossal nerve. 

From the ganglion of Nordosom we have two impor- 
tant branches: 

1. Pharyngeal branches. 

2. Superior laryngeal branches. 

The superior laryngeal branches are divided as 
follows: 

1. The external branch. 

2. The internal branch. 

1. The external branch ramifies especially the mucous 
membrane of the vocal chord. 

2. The internal branch supplies the laryngeal mucous 
membrane. 

The principal branches given off from the trunk of 
the pneumogastric nerve are as follows: 

1. Gastric branches. 

2. Esophageal branches. 

3. Superior cardiac branches. 

4. Recurrent laryngeal nerve. 

5. Anterior bronchial branches. 

6. Posterior bronchial branches. 

7. Branches to the hypogastric plexus. 

The gastric branches of the pneumogastric are sup- 



596 Ramification of Nerves. 

plied to the superior and posterior surfaces of the stomach, 
and also supply the liver and the spleen. 

The recurrent meningeal branches are very important, 
and give off a number of branches as follows: 

1. Tracheal branches. 

2. Esophageal branches. 

3. Inferior cardiac branches. 

4. Anterior branch to recurrent meningeal nerve. 

5. Posterior branch to recurrent meningeal nerve. 
The names of the nerves above sufficiently indicate 

the parts that are supplied; therefore we pass them 
without much comment. 

Spinal Accessory Nerves. — This is the eleventh 
pair of cranial nerves. They are supposed to be purely 
motor nerves. The larger portion of the fibers forming 
these nerves comes from the spinal cord. Their deep 
origin is from the nucleus of the gray matter at the back 
of the medulla oblongata below the vagii. Their exit 
from the cranial cavity is through the jugular foramina, 
while their roots of origin enter the cranial cavity through 
the foramen magnum. 

There are branches of communication between the 
second, third, fourth, and fifth cervical nerves and the 
spinal accessory nerves. 

The spinal accessory nerves assist in the formation 
of the cervical plexuses, and occasionally give fibers to 
the formation of the great auricular nerves and join the 
posterior branches of the spinal nerves. 

The Hypoglossal Nerves. (The twelfth pair of 
cranial nerves.) — Their deep origin is from the gray 
nucleus in the floor of the fourth ventricle on the upper 
portion of the medulla oblongata. Their superficial 
origin is from ten to fifteen filaments from grooves 
between anterior pyramid and olivary bodies. 

The twelfth pair of nerves receive communicating 



Cranial Nerves. 597 

branches from the first and second cervical pair of nerves, 
and give off three important branches: 

1. Lingual branches. 

2. Meningeal branches. 

3. Descendens bypoglossi. 

The terminal branches of the hypoglossal nerves supply 
the muscles of the tongue. They are anastomosed freely 
with the terminal branches of the lingual nerve. 

The meningeal branches leave the trunk in the 
condoloid foramen and pass backward to the occipital 
bone. 

Descendens hypoglossi is formed partly by fibers 
from the first three cervical nerves. The first cervical 
nerves pass horizontally forward to the hypoglossal. One 
branch from the second cervical unites with one from the 
third cervical, thus forming a long loop. 



CHAPTER IV. 
CERVICAL NERVES. 

THE cervical nerves are very apt to become involved 
and interfered with as a result of contracture of 
the musculature of the cervical region. 

The cervical region is exposed, more or less, to the 
changes of the atmosphere, and also to excessive move- 
ment that may irritate or injure the articular ligaments, 
and thus produce contractions that will narrow the 
intervertebral foramina. 

We have in all, eight pairs of cervical nerves, any of 
which may be interfered with at their places of exit 
from the neural canal, but at no other portion of their 
route of distribution can they be impinged, because at 
no other point do they pass between movable tissue as 
resistant as is nerve itself, and for further reason that 
the nutrition of these nerves at their spinal exit can be 
interfered with, as they receive their nourishment in the 
spinal centers. 

Spinal lesions, therefore, in the cervical region, and 
in all other regions, may affect the nerves by mechanical 
interference, or by occlusion of the nutrient supply to 
their centers. 

Sub-occipital Nerves. — The first pair of cervical, 
or sub-occipital nerves, make their exit from the neural 
canal between the occipital bone and the atlas. 

They make their exit through a groove in the superior 
portion of the posterior arch of the atlas, just back of 
the condyloid articulations of the atlas with the occipital 
bone. 

These nerves are accompanied and contained in a 
sheath with the vertebral arteries, veins and the gray 
rami of the vertebral plexus of the sympathetic. The 

598 



Cervical Nerves. 599 

branches from the fourth vertebral plexus and the 
vertebral arteries and veins control the metabolic pro- 
cess, and also control the nourishment and drainage of 
the posterior portion of the brain. 

This pair of nerves may be, and are frequently 
interfered with, either directly or indirectly, by lesions of 
the occipito-atlantal articulations. Lesions of these 
articulations interfering with the nerves have been termed 
by many, subluxations. They are of much more frequent 
occurrence than is commonly supposed, and especially 
is this true in people of advanced years. 

The most common lesions, narrowing the foramina, 
and thus causing an interference with the passage of the 
suboccipital nerves, are contractions of the musculature 
which will approximate the posterior arch of the atlas 
to the occipital bone, thus affecting the foramina, or 
passages of the nerves and nutrient vessels from the 
neural canal. 

The contractions may be unilateral. 

Unilateral contractions may produce conditions which 
appear to be malpositions of the atlas with relation to 
the occipital bone. From palpation we discover apparent 
malpositions, which might be enumerated under the 
following headings: 

1. Lateral condition. 

2. Anterior condition. 

3. Posterior condition. 

4. A twisted condition. 

5. An approximated condition. 

The cause of the anterior condition undoubtedly 
would be some contraction of the anterior common 
ligament, and of the anterior muscles of this region. 
This we believe to be a very rare condition and one 
that is seldom liable to occur, because of the fact that we 
have about ten times as much muscular tissue on the 



600 Ramification of Nerves. 

posterior, as we have on the anterior portion of this 
union between the occipital and the atlas. 

Posterior Condition. — The posterior condition 
would be more probable than the anterior condition, 
because of the excess of quantity of muscle tissue, com- 
paratively, of the posterior portion *of this region. 

A mere contraction of the posterior muscles would 
raise the back portion of the arch of the atlas and draw 
the transverse processes posterior, especially at their 
inferior border. The posterior condition, combined with 
the contracted condition, would make a decidedly 
detrimental lesion affecting the integrity of the sub- 
occipital nerves. 

Lateral Condition — The lateral condition may occur 
by reason of the contraction of the musculature upon one 
side of the segment, If the contraction should be on 
both sides, we would have merely a matter of uniform 
approximation, but should one side be affected mostly, 
then a unilateral contraction would produce a lateral 
condition, apparently, of the atlas with relation to the 
occipital bone. 

Twisted Condition. — This condition is perhaps rare, 
and would be the result of considerable violence to the 
patient's head. This would imply a backward or for- 
ward condition of one articulation, combined with no 
movement, or an opposite movement of the opposite 
condyloid articulation between the atlas and occipital 
bone. 

Approximated Condition. — This condition is no 
doubt the most common of all of the lesions of the occipito- 
atlantal articulations, involving the integrity of the 
suboccipital nerves. 

The approximated condition when unilateral, is 
responsible for the apparent lateral subluxations. When 
the contraction, however, is uniform on all sides, then 
we have simply a matter of contraction and uniform 



Cervical Nerves. 601 

approximation. There is no doubt that this is the 
condition with old people, which conies with the settling 
and general stiffening and contraction which ensues 
with age. 

There is a difference in the depth of the groove just 
back of the condyloid articulations in the arch of the 
atlas. In some cases, this groove is so deep that no 
amount of approximation will interfere materially with 
the nerve sheath, and with the nutrient vessels accom- 
panying the suboccipital nerves. 

In some cases, instead of the suboccipital nerve 
sheath and its contents passing over the posterior arch 
of the atlas, they pass through a solid foramen formed 
in the posterior arch of the atlas. In such cases, atlas 
lesions would be of but little importance, and the correc- 
tion of the atlas lesions by relaxation of the musculature, 
would in such cases accomplish no good whatever. 

As a result of a deep groove or of a solid foramen in 
the posterior arch of the atlas, the suboccipital nerve 
sheath and its contents are free from interference. In 
such cases, people are free from neuralgic headaches, and 
also such people will retain their memory as age advances, 
better than the people who have shallow grooves for the 
suboccipital nerves which permit of nerve interference 
and of occlusion of the drainage and nutrient vessels 
which supply the posterior portion of the brain. 

The test given in a previous chapter, which consisted 
of the patient standing erect and looking at an object 
directly overhead, is a convenient way of testing the 
condition of the occipito-atlantal articulations. Any 
interference with the movement of the head in looking 
directly overhead, would be evidence of lesions of these 
articulations on one or on both sides. 

Painful and restricted forward and backward move- 
ments of the head are especially indicative of posterior 
or anterior subluxation of the atlas. 



602 Ramification of Nerves. 

When the suboccipital nerves are interfered with and 
are impinged and tender, you will find tenderness over 
the rudimentary process, and also abnormal positions of 
the transverse processes, and you will find contracture 
of muscles attached to the occipital bone and the spinous 
processes of the cervical vertebrae. 

The most common derangement caused by abnormal 
approximation of the occiput and the posterior arch of 
the atlas, is either an anaemic or a congested condition of 
the circulation of the posterior portion of the brain. 

We have vertebral arteries supplying the posterior 
portions of the brain and the vertebral veins, the principal 
vessels of drainage of the same portion. It is because of 
pressure on these vessels caused by atlas lesions, that 
we have interference with the nutrition and drainage of 
the posterior portion of the brain. 

If the impingement of the blood vessels interferes 
more with the arteries that supply blood to the brain, 
than with the veins that drain it, then there will be an 
anaemic condition thereof. On the other hand, if the 
veins are compressed most, then the posterior portion of 
the brain will become congested. This condition is by 
far the most common and the most frequent cause of 
those full, throbbing, and congested headaches which are 
so often complained of by so many people. 

When the vertebral arteries supplying nutrition, and 
veins supplying and draining to the posterior portion of 
the brain, are interfered with, the results are far reaching 
and the effects are marked, because of the disturbance 
of the circulation and nutrition of the brain. This 
condition alters the functions of the centers that control 
the generation and transmission of the nerve force that 
produces vital action in all parts of the body, and also 
causes alteration and derangement of all automatic 
nerve action of the sympathetic portion of the nervous 
system throughout the entire body. 



Cervical Nerves. 603 

In relation with the atlas, we have also the suboccipital 
nerves, the gray rami, the superior cervical ganglion of 
the sympathetic system, and the superior vertebral 
plexuses and nerves to the walls of the vertebral arteries. 
These nerves also send nutrient or trophic branches to 
the mastoid cells and occipito-atlantal articulations. 

They join the second cervical nerves and help to form 
the recurrent nerves, and are thus distributed to the 
meninges of the brain and upper portion of the spinal 
cord, and to the vertebral articulation of the upper 
cervical vertebrae. 

They connect, by direct communication, with the 
vertebral plexus, the ninth cranial nerve, tenth cranial 
nerve, twelfth cranial nerve, and the meningeal nerves. 

The suboccipital nerves receive branches of communi- 
cation from other nerves and ganglia as follows: 

1 . Second pair of cervical nerves. 

2. The superior cervical ganglia. 

3. Branch of vagus to first and second cervical. 
Impingement of the suboccipital nerves, then, may 

cause quite a diversity of ailments of the cephalic organs; 
may cause loss of memory, dullness of mental powers; 
in fact, general derangement of the mental faculties. 
Insanity may come from abnormal function of nerves, 
or from alteration of the nourishment and drainage of 
the encephalon, due to interference with the integrity of 
the first cervical or suboccipital pairs of nerves. 

All functional action of the organs of the body may 
and do become more or less impaired because of a con- 
gested or an anaemic condition of the brain, which 
contains nerve centers for the origination, reception and 
transmission of nerve impulse to all parts of the system. 

The suboccipital nerves by joining the pneumogastric 
nerves affect their integrity. Interference with them, 
therefore, will and does affect the integrity of the func- 
tional activity of the pelvic cavity. 



604 



Ramification of Nerves. 



The principal viscera affected directly by the pneu- 
mogastric and indirectly by the suboccipital nerves are 
the following: 

Ears. Heart. 

Larynx. Liver. 

Pharynx. Stomach. 

Intestines, etc. 
And all the viscera of the cavities of the trunk. 
From suboccipital impingement and nutritive derange- 
ment of the brain we may get such ailments as: 



Iritis. 

Vertigo. 

Abscess. 

Delirium. 

Epilepsy. 

Cataract. 

Glaucoma 

Apoplexy. 

Otorrhea. 

Keratitis. 



Delusions. 

Dizziness. 

Retinitis. 

Pterygium. 

Drowsiness. 

Depressions. 

Conjunctivitis. 

Loss of memory. 

Mental dullness. 



Hardened ear wax. 
Polypi of the ear. 
Buzzing in the ear. 
Ringing in the ear. 
Catarrh of the ear. 
Optic nerve atrophy. 
Softening of brain. 
Neuralgic headaches. 
Running from the ear. 
Conjugate deviations. 



Tumors of brain. 

Impingement of the suboccipital nerves will cause an 
interference with the nerve supply to the scalp, and also 
the meninges of the brain, and the same will cause 
neuralgic headaches, especially those of the front of the 
head or forehead, and around and over the orbit of the 
eye. Many headaches may be stopped by an adjustment 
of the atlas. 

Motor disturbances of the eye and its appendages 
result from lesions that hinder the origin of the motor 
impulses or transmission of them to the eye. Impulses 
from the spinal cord pass through the cavernous plexus 
from the superior cervical ganglion to the eye and its 
appendages. Atlas lesions interfere with the free -trans- 
mission of these impulses; these atlas lesions may 
interfere by direct pressure of the bony parts upon the 
nerves and blood vessels, or by muscular or ligamentous 



Cervical Nerves. 605 

contractions or a tightening of the adjacent tissues, and 
a consequent pressure upon vessels or nerves or ganglia. 

By spinal adjustment the writer has demonstrated 
that both trophic and motor impulses travel from the 
spinal cord to the cranial nerves. This has been done 
by opening the channels for the spinal exit from the 
neural canal, and in this way we have restored power of 
function to the optic and auditory nerves. These impulses 
may pass by way of the superior cervical ganglion and 
the cavernous plexuses of the sympathetic nervous 
system. 

Muscles receiving nerve supply from the first cervical 
or suboccipital pair of nerves: 

1. Complexus. 

2. Superior oblique. 

3. Rectus capitis laterals. 

4. Rectus capitis anticus major. 

5. Rectus capitis anticus minor. 

6. Rectus capitis posticus major. 

7. Rectus capitis posticus minor. 

Second Pair of Cervical Nerves. — This pair of 
nerves make their exit from between the lamina of the 
atlas and the pedicles of the axis through the foramina 
formed by notches in the parts named. 

The second pair of cervical nerves receive communi- 
cating branches from the first pair of ganglia of the 
sympathetic system from the first and the third pair of 
cervical nerves. They contribute branches to the forma- 
tion of the following nerves and some of these nerves are 
mostly formed from the second pair of cervical nerves. 

1. Small occipital. 

2. Third occipital. 

3. Auricular nerves. 

4. The great occipital. 

5. Great auricular nerves. 

6. Posterior auricular nerves. 



606 Ramification of Nerves. 

They send branches to the mastoid cells and help to 
form the loop between the first and the second pairs of 
cervical nerves. 

They supply the back of the head as far forward as 
the vertex, the sides and front of the neck to the chin and 
to the sternum, the external ears, and communicate with 
the facial nerves or with the terminal ganglia associated 
therewith. 

They supply the following muscles: 

1. Splenium. 

2. Trapezius. 

3. Complexus. 

4. Auricular. 

5. Trachelo-mastoid. 

6. Occipito-fron talis. 

7. Sterno-cleido-mastoid. 

These nerves ramify some of the nerves and parts, 
as the suboccipital nerves and some of the malfunction 
arising from the impingement of them is similar to that 
coming from interference with the suboccipital nerves. 

Third Pair of Cervical Nerves. — This pair of 
nerves make their exit from the neural canal between the 
pedicles of the axis and the pedicles of the third cervical 
vertebra. They communicate with the second and 
fourth pair of cervical nerves, and receive gray rami 
communicantes from the superior cervical ganglia of the 
sympathetic system and they help to form the superior 
cervical plexus in, connection with the first, second, and 
fourth pairs of cervical nerves. They help in the 
formation of the small occipital and the great auricular 
nerves, and they contribute anastomotic branches to the 
formation of the phrenic nerves. 

They supply motor impulses to the: 

1. Trapezium. 

2. Longus colli. 

3. Scalenus medium. 



Cervical Nerves. 607 

4. Trachelo mastoid. 

5. Multifidus spina. 

6. Rectus anticus major. 

7. Levator anguli. 

8. Scapular sterno-cleido-mastoid. 

They also supply sensation to the sides and front of 
the neck and the scalp, back of the ear. 

Impingement of the third pair of cervical nerves affects 
musculature contraction, the sensory integrity of the 
organs of special sense and the diseases of the eye and 
ear and mucous membrane of the nose and fauces. 

Impingements impairing the integrity of this pair of 
nerves which distribute the accelerator impulses to the 
heart and exert a vasoconstrictor effect on the lungs. 
Excessive or efficient action of the sweat and sebaceous 
secretions and disorders of the face are produced by 
interference with these nerves. Such diseases as neu- 
ralgia of the face, teeth, jaws and gums, dull headaches, 
catarrh, polypi, tumors of the nose, cheeks and lower jaws, 
and contraction of the muscles of the neck, may result 
from pressure on the third pair of cervical nerves. 

The Third Cervical Nerves. • — The third pair of 
cervical nerves pass from the neural canal between the 
pedicles of the axis and the third cervical vertebra. This 
pair of nerves send communicating branches to the 
second and fourth pair of cervical nerves. They also 
join into the formation of the superior cervical ganglia. 

They contribute branches to the formation of the 
small occipital, the great auricular nerve, and also give 
off an auxiliary branch to the formation of the phrenic 
nerve and send communicating branches to the hypo- 
glossal nerves. 

This pair of nerves receives communicating branches 
from the second and from the fourth pair of cervical 
nerves and also gray rami communicantes from the 



608 Ramification of Nerves. 

superior cervical ganglia of the sympathetic system or 
cords. 

The muscles supplied by the third pair of cervical 
nerves partly or entirely are as follows: 

1. Trapezius. 

2. Longus colli. 

3. Scalenus anticus. 

4. Multifidus spinse. 

5. Rectus anticus major. 

6. Sterno-cleido-mastoid. 

7. Levator anguli scapulae. 

The third pair of cervical nerves send branches of 
ramification by way of the occipital nerves into the 
region of the scalp posterior to the ears. The integrity 
of the function of the ears, the eyes, mucous membranes 
of the nose and pharynx are disturbed by interference 
with the nerves. 

This pair of nerves exerts a vasoconstrictor influence 
upon the lungs and an accelerator influence upon the 
heart. These nerves are usually involved in skin dis- 
orders, such as pimples, eruptions of the skin, and affect 
the skin of the face and neck. 

These nerves join the terminal ganglia of the sympa- 
thetic, and thus affect the sebaceous and sweat glands of 
the face. These nerves are usually involved in cases of 
catarrh, nasal polypi, tumors of the nose and diseases of 
the teeth and gums. 

The ramification of these nerves is very nearly the 
same as that of the fourth pair of cervical nerves. In 
all cases of catarrhal infection of the nasal passages 
particular attention should be given to any lesions that 
would involve the integrity of the third pair of cervical 
nerves. 

Fourth Pair of Cervical Nerves. — The fourth pair 
of cervical nerves make their exit from the neural canal 
between the pedicles of the third and fourth cervical 



Cervical Nerves. 609 

vertebrae. They give off branches to the third and fifth 
pair of cervical nerves and also help in the formation of 
the cervical plexus. 

They receive communicating branches from the third 
and fifth pair of cervical nerves and also gray rami 
communicantes from the superior cervical ganglia of the 
sympathetic. 

The fourth pair of cervical nerves are what we might 
consider central place in the cervical region. They con- 
tribute most of .the fibers that enter into the formation 
of the phrenic nerves. The phrenic nerves, however, 
receive auxiliary branches from the third and fifth pair 
of cervical nerves. 

The fourth pair of cervical nerves are very important 
for the reason of their influence upon the lungs, upon the 
heart, supplying, as they do, the plurae, the pericardium 
and the diaphragm; they also enter into the formation 
of the solar plexus and their fibers are traced as low as 
the supra-renal capsules of the kidneys. 

These nerves also have an important influence upon 
some of the organs of the cephalic region. 

The muscles partially supplied by the fourth pair of 
cervical nerves are as follows: 

1. Trapezium. 

2. Complexus. 

3. Semi-spinalis. 

4. Scalenus medius. 

5. Supra-clavicular. 

6. Inter-transversales. 

7. Transversales cervices. 

8. Levator anguli scapulae. 

The ramification of these nerves is quite extensive. 
They ramify the pharynx, the alveolar arches of the upper 
and lower teeth, and the upper end of the trachea, and 
they also send filaments to the brachial plexus and to 
its parts. They supply the pericardium, plurae and the 



610 Ramification of Nerves. 

diaphragm and ramify some of the small intestines and 
supra-renal capsules of the kidneys. 

A number of ailments may result from an involvement 
affecting the integrity of this pair of nerves: nasal catarrh, 
nasal polypi, nosebleed, barber's itch, and all diseases 
of the teeth. Since the fourth pair of nerves especially 
supply and have to do with the pupil of the eye and sight 
of the eye, such diseases as amaurosis, far sight, near 
sight, color blindness, etc., ensue as a result of interfer- 
ence with the fourth pair of cervical nerves. 

The fourth pair of cervical nerves control the function of 
contraction and expansion of the plurse and the diaphragm 
and have much to do with the circulation within the 
lungs. For this reason adjustment of the fourth cervical 
nerves will relieve most all forms of congested headaches, 
which relief seems to be due to the equalization of the 
circulation of the thoracic and the cranial cavities. 

Nine-tenths of all headaches may be relieved almost 
instantly by a fourth cervical adjustment to relieve or 
stimulate the fourth pair of cervical nerves. 

We have been enabled to restore a normal condition 
of the mind in cases of insanity by an adjustment of the 
fourth pair of cervical nerves. We have also been able 
to relieve certain lung affections and infections of the 
respiratory tract. 

Stimulation of the fourth pair of cervical nerves is an 
important measure in the resuscitation of patients who 
have sometimes fallen with sudden unconsciousness. 

Percussion over this region will cause vasoconstric- 
tion upon the lungs and is an auxiliary measure in con- 
trolling hemorrhage in pulmonary conditions; in disease 
of the gums, as alveolar pyorrhea. Relief of the fourth 
cervical nerves by removing all interference with their 
function is a positive cure for diseases of the teeth and 
gums. 

Percussion over the spinous processes of the fourth 



Cervical Nerves. 611 

and fifth cervical vertebrae is the best method of stim- 
ulation used in restoring patients from loss of consciousness 
or heart failure. 

Fifth Cervical Nerves. — The fifth pair of cervical 
nerves are larger than the fourth. They give branches 
to the fourth and sixth pair of cervical nerves. They 
also receive branches from the fourth and sixth pair of 
cervical nerves and gray rami from the middle cervical 
ganglion of the sympathetic system. They help supply 
the following muscles : 

1. Biceps. 

2. Deltoid. 

3. Splenius. 

4. Complexus. 

5. Serratus magnus. 

6. Pectoralis major. 

7. Multifidus spinge. 

8. Scaleni and teres major muscles. 

9. Trachelo mastoid and branches to the shoulder. 
The fifth pair of cervical nerves send branches directly 

into the formation of the brachial plexuses which supply 
the upper extremities. 

The fifth pair of cervical nerves give off branches to 
the formation of the long posterior thoracic nerves. 
Involvement of the fifth pair of cervical nerves may 
interfere with the integrity of the upper extremities or 
with the respiratory muscles of the chest. 

Impingement or interference with the fifth pair of 
cervical nerves may also involve the lungs, heart, dia- 
phragm, pericardium, etc., because of the auxiliary 
branch of the fifth pair of cervical nerves which enter 
into the formation of the phrenic nerves. The fifth pair 
of cervical nerves ramify the following muscles: 

1. Biceps. 

2. Deltoid. 

3. Subclavius. 



612 Ramification of Nerves. 

4. Terres minor. 

5. Terres major. 

6. Supraspinatus. 

7. Infraspinatus. 

8. Serratus magnus. 

9. Pectoralis major. 

10. Brachialis anticus. 

11. Rhomboideus minor. 

12. Rhomboideus major. 

The fifth pair of cervical nerves send branches of 
ramification into the esophagus, upper trachea, and 
bronchial tubes. They ramify the thyroid glands and 
for this reason affect materially the entire system. This 
is owing to the influence of the colloid secretion of the 
thyroid glands. It is claimed by some that adjustments 
freeing and stimulating the action of the thyroid glands 
is especially helpful in the treatment of infectious diseases 
or any condition of lowered vital activity or lack of 
auto-protection. 

The Sixth Cervical Nerves. — The sixth pair of 
cervical nerves make their exit from the neural canal 
between the pedicles of the fifth and sixth vertebrae. 
They give off branches to the fifth and seventh pairs 
of cervical nerves and receive communicating branches 
from the same pair of nerves and also gray rami communi- 
cantes from the middle cervical ganglia of the sympathetic 
system. 

This pair of nerves enter into the formation of the 
brachial plexus and help in the formation of the thoracic 
nerves. They also give off communicating branches to 
the circumflex, the subscapular, median muscle, cutaneous 
and muscle spiral, supra scapular, anterior and long 
posterior thoracic nerves. They supply the skin over 
the deltoid, and radial side of the arm and forearm, and 
to the back of the neck, and they penetrate and help to 
supply the following muscles: 



Cervical Nerves. 613 

1. Biceps. 

2. Triceps. 

3. Deltoid. 

4. Subclavius. 

5. Lumbricales. 

6. Terres minor. 

7. Terres major. 

8. Subscapularis. 

9. Infraspinatus. 

10. Supraspinatus. 

11. Supinator longus. 

12. Adductor pollicis. 

13. Oppenens pollicis. 

14. Brachialis anticus. 

15. Pronator radii terres. 

16. Flexor carpi radialis. 

17. Supinator radii brevis. 

18. Extensor brevis pollicis. 

19. Extensor carpi radialis brevior. 

20. Extensor carpi radialis longior. 

These nerves help to supply and have an influence 
upon the thyroid gland, esophagus, upper trachea, and 
bronchial tubes. 

Seventh Cervical Nerves. — The seventh pair of 
cervical nerves pass from the neural canal above the 
pedicles of the seventh and between them and the 
pedicle of the sixth cervical vertebra. This pair of nerves 
give communicating branches to the sixth and eighth 
pair of cervical nerves and receive communicating 
branches from the sixth and eighth pair of cervical 
nerves and from the inferior ganglion of the sympathetic 
system. The seventh pair of cervical nerves enter into 
the formation of the brachial plexus, also they affect the 
thyroid glands, trachea, bronchial tubes, esophagus, and 
any impingement of these nerves that involve their 



614 Ramification of Nerves. 

integrity may interfere with the muscles of the arm, 
muscles of the chest, and the muscles of respiration. 

The muscles supplied by the seventh pair of cervical 
nerves are as follows: 

1. Subscapularis. 

2. Serratus magnus. 

3. Extensor indicis. 

4. Coraco-brachialis. 

5. Extensor minimi digiti. 

6. Extensor carpi ulnaris. 

7. Extensor longus pollicis. 

8. Extensor communis digitorium. 

9. Extensor carpi radialis brevier. 

10. Extensor carpi radialis longior. 

11. Extensor ossi metacarpi pollicii. 
Involvement of the seventh pair of cervical nerves 

will cause affection of the trachea, larynx, esophagus, 
and organs of voice. 

Eighth Pair of Cervical Nerves. — The eighth pair 
of cervical nerves make their exit from the spine between 
the pedicles of the seventh cervical and the first dorsal 
vertebrae. They also receive communicating branches 
from the seventh and the first thoracic pair of nerves. 
They receive gray rami branches from the inferior 
cervical ganglia of the sympathetic. The eighth pair of 
cervical nerves have a decided influence upon the organs 
of voice, affect the trachea, the bronchial tubes, larynx, 
pharynx, and help in the formation of the brachial 
plexus. 

Any involvement of the eighth pair of cervical nerves 
affects the integrity of the musculature of the upper 
extremity. They also contribute to the formation of the 
nerves which supply the muscles of expiration. The 
eighth pair of cervical nerves send branches of ramifica- 
tion into the following muscles: 



Cervical Nerves. 615 

1. Triceps. 

2. Anconeus. 

3. Lumbricales. 

4. Sub-scapularus. 

5. Palmaris brevus. 

6. Palmaris longus. 

7. Palmer interossi. 

8. Dorsal interossi. 

9. Pectoralis minor. 

10. Pectoralis major. 

11. Flexor profundus. 

12. Brachialis anticus. 

13. Pronator quadra tus. 

14. Flexor longus ulnaris. 

15. Oppones minimi digiti. 

16. Flexor longus pollicis. 

17. Abductor minimi digiti. 

18. Flexor brevis pollicis. 

19. Flexor sublimis digitorium. 

20. Abductor obliquus pollicis. 

21. Flexor brevis minimi digiti. 

22. Abductor transversus pollicis. 

The Superior Cervical Ganglia. — The superior 
cervical ganglia of the sympathetic lie opposite the 
second and third cervical vertebrae behind the internal 
carotid artery. They send branches of communication 
into the first four pairs of cervical nerves, and also send 
rami into the roots and ganglia of the trunks of the 
cranial nerves. 

This ganglia connects with the petrious ganglia, the 
ninth and the twelfth pair of cranial nerves, and through 
the carotid plexus and cavernous plexus the superior 
cervical ganglia connect with all the other pairs of cranial 
nerves. 

The deep origin of impulses which reach the superior 
cervical ganglia come from the upper thoracic nerves via 



616 Ramification of Nerves. 

the sympathetic cords and they are conveyed by way of 
the white rami communicantes from the upper cervical 
nerves which join the gangliated cords of the sympathetic 
and pass upward forming the upward stream. 

The functions of the fibers joining the superior cervical 
ganglia are vasomotor, pilomotor, secretory to the sweat 
and sebaceous glands affecting the skin of the neck and 
head. 

The nerve impulse of the superior cervical ganglia 
reaches the eye, ear, and other cephalic organs via the 
cavernous plexus and the ophthalmic division of the 
fifth cranial nerves and the carotid plexuses. 

The superior cervical ganglia are affected by lesions 
of the atlas, axis, and third cervical vertebra, and their 
integrity is also affected by lesions or subluxations of 
the upper thoracic vertebrae because of interference with 
the normal nerve impulse of the white rami communi- 
cantes coming from the upper dorsal nerves. 

The superior cervical ganglia sends branches into the 
cardiac ganglia situated in the thoracic cavity. 

The Middle Cervical Ganglia.— This ganglia is 
also one of the ganglia of the sympathetic cords situated 
between the superior and inferior cervical ganglia of the 
cords of the sympathetic. 

These ganglia may be affected by lesions of the fifth 
and sixth cervical vertebrae as they lie opposite the 
transverse processes of the vertebrae of this region. 

These ganglia supply pilomotor and secretory func- 
tions to the sweat and sebaceous glands of the area sup- 
plied by the fifth and sixth pairs of cervical nerves. 

These ganglia send branches of communication to 
the fifth and sixth pairs of cervical nerves which they 
accompany throughout their entire ramification. The 
middle cervical ganglia also send an important branch to 
the cardiac plexus of the thoracic cavity. Stimulation 



Cervical Nerves. 617 

of the middle cervical ganglia has a vasoconstrictor 
influence upon the lungs. 

The Inferior Cervical Ganglia. — This ganglia is 
the third ganglia in the cervical region of the gangliated 
cords of the sympathetic system. These ganglia lie 
between the transverse processes of the seventh cervical 
vertebra and the first rib and may be disturbed by lesions 
of the seventh cervical vertebra or first thoracic vertebra. 

The inferior cervical ganglia send direct branches of 
ramification into the cardiac plexus of the thoracic cavity, 
they supply vasomotor fibers to the subclavian and 
mammary arteries and send communicating branches to 
the phrenic nerves. They also send gray rami communi- 
cantes to the cardiac plexus. They help to form the 
thyroid plexus by communicating rami of the stellate 
ganglia and supply the inferior thyroid ganglia and 
secretory cells of the inferior maxillary glands. 

Gray rami communicantes from these ganglia join 
the seventh and eighth pairs of cervical nerves and 
accompany them in their ramification, and also part of 
the branches of the gray rami joining these nerves pass 
back to the segments of the cord from which the 
cervical nerves originate. 

The Cervical Region in General. — The lower cer- 
vical nerves are not so often interfered with as are those 
of the middle cervical region, but they are more fre- 
quently impinged than are the nerves of the upper 
thoracic region. We have, however, contractions of the 
muscles and ligaments of the vertebrae of all the cervical 
region which cause lesions or impingement of the spinal 
nerves of those segments. The muscular and ligamentous 
contractions may be the result of irritation of the sensory 
nerve causing reflex motor nerve action as a result of 
external excitation due to exposure. 

Some of the results of impingement of the lower 
cervical nerves are diseases of the arm, hands, such as 



618 Ramification of Nerves. 

felons, writers' cramp, boils, etc. This is due to the fact 
that the lower cervical nerves enter into the formation 
of the brachial plexus. 

Any interference with the normal nerve supply in 
this region may involve the integrity of the muscular 
action and health of the upper extremities. These nerves 
contribute part of the nerve supply to the muscles of 
both inspiration and expiration. 

Non-action of the Muscles of Respiration. — Choking 
attacks, coughing attacks, headaches, dizziness, hay 
fever, asthma, especially bronchial asthma, may be the 
result of lesions of the lower cervical nerves. Constric- 
tion of the lungs and also accelerator influences acting 
upon the heart are influenced by stimulation of the 
cervical nerves. The expansion of the chest, plurge and 
diaphragm are controlled to a great extent by the middle 
cervical nerves, while the lower cervical nerves send 
branches to the muscles of respiration. 

The cervical vertebra often are not in exact normal 
situation as is evidenced by their spinous processes being 
out of proper alignment. Any deviation from the proper 
alignment of the cervical spinous processes is positive 
evidence of a subluxation in this region. Probably the 
most common ailment in the cervical region is that of 
musculature contraction. We know that the muscle 
contraction produces approximation and necks will 
become stiff and remain so because of the contraction 
remainder. 

The important influence of the cervical nerves upon 
the organs of the cephallic region is by reason of the 
connections of the white rami from the upper cervical 
nerves to the cranial nerves. From the cervical nerves 
we may influence the functions of organs all the way 
from the adrenal capsules below to the top of the head 
above. One of the most important results of contracture 



Cervical Nerves. 619 

of the muscles or ligaments of the vertebrae of the cervical 
region is the interference that is caused with the nourish- 
ment both of the brain itself and with the segments of 
the spinal cord of the cervical region. 



CHAPTER V. 
CERVICAL PLEXUS. 

THIS plexus is formed by the ansae cervicales first, 
second, and third, the formation of which is 
between the upper four cervical nerves. By 
slender communications between these loops and the 
anterior divisions of the first four cervical nerves the 
plexus is constituted. It lies behind sterno-mastoid, in 
front and external to the upper cervical vertebrae, and 
in front of the upper portion of the scalenus medius and 
levator anguli scapulae. It is covered by the deep layer 
of the cervical fascia. The carotid sheath is an antero- 
external relation. Motor and sensory nerves come from 
this plexus. The motor fibers supply the deep muscles 
of the neck, and the upper portions of scalenus anticus, 
scalenus medius, levator anguli scapulae and the dia- 
phragm. By joining the hypoglossal and the spinal 
accessory nerves they supply indirectly sterno-mastoid, 
trapezius and the infra-hyoid muscles. The sensory dis- 
tribution of the cervical plexus comprises the pinna, 
the region behind it, the parotid region, and the skin of 
neck as far as the anterior border of trapezius. Down- 
ward this area of distribution extends to the skin, 
covering the clavicular portion of pec toralis major and the 
anterior half of deltoid. 

Besides the filaments innervating the deep muscles of 
the neck the following nerves come from the cervical 
plexus: 

1. Phrenic nerve. 

2. Small occipital. 

3. Great auricular nerve. 

4. Supra-clavicular nerves. 

5. Great superficial cervical nerve. 

620 



Cervical Plexus. 621 

1. Phrenic Nerve. — This is a mixed nerve, but 
preponderantly motor. It innervates the diaphragm, 
containing also sensory fibers for pleura, pericardium, and 
peritoneum. Its fibers are mainly derived from the 
anterior division of fourth cervical, but some come from 
third cervical, and especially fifth cervical nerves. The 
phrenic nerve runs obliquely downward and forward 
on the scalenus anticus, and passes behind the sterno- 
clavicular joint, between subclavian vein and artery. In 
the thorax, the right phrenic nerve lies external to the 
superior vena cava, passes along the right side of the 
pericardium, in front of the root of the lung, together 
with the arteria comes nervi phrenici, and reaches the 
diaphragm in front and to the right of the opening for 
the inferior vena cava. The left phrenic nerve passes 
along the left side of the pericardium, behind the apex 
of the heart, and then turns forward to the diaphragm. 
It enters this structure more anteriorly and further away 
from the middle line than its fellow, with which it anasto- 
moses. 

The course of the left phrenic nerve is thus longer 
than that of the right. 

In their course the phrenic nerves anastomose with 
the middle and inferior cervical ganglia and the nerves 
to the subclavius. They send filaments to the peri- 
cardium and to the pleurse. At the diaphragm they 
ramify partly on its pleural surface, and partly on its 
peritoneal surface, after having pierced it near the open- 
ing for the inferior vena cava. The latter ramifications 
also supply the inferior vena cava and the suprarenal 
capsules. On the right side there is a communication of 
the phrenic nerve with the solar plexus. Thus on the 
inferior surface of the diaphragm the phrenic plexus is 
formed, which is in relation with the phrenic ganglion. 

2. Small Occipital, coming from second ansa, 
emerges about the middle of the posterior border of 



6'22 Ramification of Nerves. 

sterno-mastoid, follows this border upward and back- 
ward, and divides at the mastoid process into an anterior 
and posterior branch. The latter anastomoses with the 
great occipital nerve, and ramifies in the skin of the 
occipital region, externally to the former. The anterior 
branch anastomoses with the great auricular nerve, and 
innervates the skin over the mastoid process. 

3. Great Auricular Nerve, purely sensory, like 
the former, comes from the second ansa just below the 
small occipital nerve. It also winds round the posterior 
border of sterno-mastoid slightly below the former 
nerve, passes on to the anterior surface of that muscle, 
and runs upward and slightly forward. At the lobule 
of the ear it divides into a large posterior and smaller 
anterior branch. The latter sends a branch to the 
parotid gland, which anastomoses with twigs from the 
facial nerve, and ends in the skin of the temporal region, 
some fibers reaching the outer surface of the pinna. The 
posterior branch ramifies the skin covering the inner 
surface of the pinna. 

4. Supra-clavicular Nerves are chiefly or com- 
pletely sensory. They come from the anterior division of 
the fourth cervical nerve and ansa third, emerge at the 
posterior border of sterno-mastoid, and go partly for- 
ward (anterior branches) to the internal and superior 
pectoral regions, partly over the middle and outer por- 
tions of the clavicle (middle and posterior branches) to 
the skin covering the first four ribs, the axilla, and the 
acromion. In many cases a large motor nerve from the 
anterior division of the fourth cervical nerve runs with the 
supra-clavicular nerves to the outer portion of trapezius, 
supplying it. 

5. Great Superficial Cervical Nerve, purely sen- 
sory, contains the bulk of the anterior division of the 
third cervical nerve. Winding just below the great 
auricular nerve around the posterior border of the 



Cervical Plexus. 



623 




Showing sensory innervation of the anterior part of the body. (After 
Eisendrath.) 



624 Ramification of Nerves. 

sterno-mastoid,, it runs forward, covered by platysma, 
crosses behind the external jugular vein, and supplies the 
anterior and inferior portions of the neck. The trunk 
runs further forward, sends one or more branches 
upward, which anastomose with the cervical branch of 
the facial nerve, and ends by ramifying in the skin of 
the hyoid and mental regions. 

BRACHIAL PLEXUS. 

A S has already been indicated, three primary trunks 
^ ^ enter into the formation of the brachial plexus. 
These trunks are formed by the united anterior divisions 
of the fifth and sixth cervical nerves, by the anterior 
division of the seventh cervical nerve, and by the united 
anterior division of the eighth cervical nerve, and bulk 
of the anterior division of the first dorsal nerve. 

The second primary trunk bifurcates, one branch 
joining the first, the other the third primary trunk. Thus 
two secondary trunks are formed; the third secondary 
trunk is due to the fact that fibers leave each secondary 
trunk and unite at an acute angle with each other. The 
uppermost of these secondary trunks joins with a portion 
of the lowest secondary trunk. Now, three tertiary final 
trunks are formed apart from the smaller nerves which 
are given off. 

The first tertiary trunk, the most external one in the 
arm, splits into the median and musculo-cutaneous 
nerves. This tertiary trunk corresponds to the upper- 
most secondary and a portion of the lowest secondary 
trunk. The second tertiary trunk, the most posterior 
one in the arm, gives off the musculo-spiral and circumflex 
nerves. It corresponds to the middle secondary trunk. 
The third tertiary trunk, corresponding to the remaining 
portion of the lowest secondary trunk, furnishes the 
ulnar, internal cutaneous, and lesser internal cutaneous 
nerves. 



Brachial Plexus. 



625 




Showing sensory innervation of the posterior part of the body. (After 
Eisendrath.) 



626 Ramification of Nerves. 

The brachial plexus supplies with motor fibers the 
entire upper limb — i. e., the muscles of shoulder, arm, 
forearm, and hand, and also those of the chest and back 
which move the arm and shoulder, with exception of the 
trapezius. 

The sensory distribution of the brachial plexus extends 
over the entire skin covering the upper limb and shoulder, 
with exception of the anterior surface of the latter, which 
is innervated by the supra-clavicular nerves. 

The brachial plexus passes from the point where its 
constitutional nerves emerge, obliquely downward and 
outward between clavicle and first rib, into the axilla. 
Its primary trunk lies above the subclavian artery on 
the scalenus medius; they then pass between scalenus 
medius and anticus into the supra-clavicular fossa, 
where they are covered by sterno-mastoid, omo-hyoid 
and the cervical fascia. The plexus then approaches the 
upper border of the clavicle, near which the transversalis 
colli artery passes the plexus or goes through its meshes. 
The plexus then passes between first rib and clavicle, 
separated from the latter by subclavius muscle. At this 
point the subclavian (axillary) artery touches it inter- 
nally; the artery then becomes an anterior relation of 
the plexus. The latter then passes into the axilla behind 
pectoralis major and minor, where it lies between serratus 
magnus and subscapularis. The axillary artery now 
passes through the meshes of the plexus and becomes a 
posterior relation. 

The nerves coming from the plexus are: 

1. Ulnar nerve. 

2. Median nerve. 

3. Circumflex nerve. 

4. Nerve to subclavius. 

5. Long thoracic nerve. 

6. Musculo-spiral nerve. 

7. Supra-scapular nerve. 



Brachial Plexus. 627 

8. Nerve to the rhomboids. 

9. Long subscapular nerve. 

10. First subscapular nerve. 

11. Third subscapular nerve. 

12. Musculocutaneous nerve. 

13. Internal cutaneous nerve. 

14. Lesser internal cutaneous nerve. 

15. External anterior thoracic nerve. 

16. Internal anterior thoracic nerve. 

1. Ulnar Nerve is derived from the inner tertiary 
trunk of the brachial plexus. Situated at first postero- 
internally to the axillary artery (brachial artery resp.), 
separated from the artery by the median nerve, it gradu- 
ally leaves that vessel, and passes with the inferior pro- 
funda artery backwards behind the internal intermuscular 
septum. It becomes practically subcutaneous behind the 
internal condyle, but passes again on to the anterior 
surface. Between flexor carpi ulnaris and flexor pro- 
fundus digitorum it approaches the ulnar artery, and 
runs along its inner side to the anterior annular ligament. 
It passes superficially to this ligament, but deep to the 
palmar fascia, into the palm of the hand (superficial 
ulnar nerve). The ulnar nerve has no branches in the 
arm. Its motor fibers go to the flexor carpi ulnaris, the 
ulnar portion of flexor profundus digitorum, palmaris 
brevis, abductor transversus and obliquus pollicis, the 
hypothenar muscles, the third and fourth lumbricals, and 
the palmar and dorsal interossei. The sensory distri- 
bution comprises those areas of the palm and anterior 
digital surfaces which are not supplied by the median 
nerve, also the dorsum of the hand as far as it lies inter- 
nally to a line extending from the styloid process of the 
ulna, with an outward convexity to the middle line of 
the dorsum of the middle finger. The ulnar nerve also 
supplies the back of the elbow-joint and the ligaments of 
the hand. 



628 Ramification of Nerves. 

Its branches are: 

., ^ , , , j The superficial branch. 

1. Palmar branch < m , , , , 

( The deep branch. 

2. Muscular branches to flexor carpi ulnaris. 

3. Dorsal cutaneous branch. 

4. Palmar cutaneous branch. 

5. Muscular branches to flexor profundus digitorum. 

1. Palmar Branch, the terminal branch of the ulnar 
nerve, passes behind the palmaris brevis, and divides 
into a superficial and a deep branch. 

(a) The superficial branch, the larger of the two, 
passes in the direction of the main trunk, internally to 
the hook of the unciform bone, superficially to the flexor 
brevis minimi digiti. It gives branches to palmaris 
brevis and the skin, and then splits into the common 
digital branches fifth and sixth. The former supplies the 
fourth lumbricals and splits into a branch for the ulnar 
border of the ring finger and a branch for the radial 
border of the little finger. The sixth palmar digital 
branch runs along the ulnar border of the little finger. 

(b) The deep branch anastomoses by a filament 
which winds round the pisiform bone with the dorsal 
branch, supplies opponeus, flexor brevis, and abductor 
minimi digiti, and disappears with the deep palmar 
branch of the ulnar artery between the latter two muscles. 
In its course it describes a marked curve around the 
hook of the unciform bone, and goes to supply adductor 
transversus and obliquus pollicis and the first dorsal 
interosseous. During the last part of its course it sends 
fibers to the dorsal and palmar interossei, and to the 
second and third lumbricals. 

2. Muscular Branches to Flexor CarpiUlnaris. — 
They are given off where the ulnar nerve passes from 
the back of the internal condyle to the anterior surface 
of the forearm. 

3. Dorsal Cutaneous Branch begins at the lower 



Brachial Plexus. 629 

third of the fore-arm, passes between ulna and flexor 
carpi ulnaris backwards to the dorsal surface, pierces the 
deep fascia, and appears at the styloid process of ulna. 
It gives off external branches to the skin of the dorsum 
of the hand, which anastomose with the radial nerve, 
and then divides into three branches. The internal 
one (nervus dorsalis minimi digiti ulnaris) runs along the 
ulnar border on the dorsal surface of the little finger. 
The middle branch divides into two branches, one passing 
along the radial border of the little finger (nervus dor- 
salis minimi digiti radialis), the other running along the 
ulnar border of the ring finger. The outer branch also 
splits into two branches, one for the radial side of the 
ring finger, and one for the ulnar side of the middle finger. 

4. Palmar Cutaneous Branch begins at the junc- 
tion of upper and middle thirds of the fore-arm, follows 
the ulnar artery as far as the middle of the fore-arm, and 
then becomes superficial between the tendons. It now 
pierces the deep fascia, and runs downwards on it to the 
skin covering the inner part of the wrist. 

5. Muscular Branches to Flexor Profundus 
Digitorum, which are given off where the ulnar nerve 
approaches the ulnar artery. 

2. Median Nerve. — As described above, the median 
nerve is formed by the junction of two roots, the larger 
one being derived from the upper secondary trunk, and 
the smaller one from the lower secondary. Both sec- 
ondary trunks lie to either side of the axillary artery; 
the roots of the median join at an acute angle in front of 
the vessel, which is thus gripped by a loop. The median 
nerve thus lies in front of the artery. It follows the 
brachial artery, being at first antero-external to it, then 
in front, and finally in the lower third on its antero- 
internal border. In the antecubital space it passes behind 
the median basilic vein inwards, behind pronator radii 
teres and flexor carpi radialis. It then crosses the ulnar 



630 Ramification of Nerves. 

artery just below its origin. From this vessel it receives 
the arteria comes nervi mediani. The nerve thus gets to 
the middle line, passes between flexor sublimis digitorum 
and flexor profundus, and enters the hand by passing 
under the anterior annular ligament, anteriorly to the 
tendons of the two muscles mentioned. It now splits 
into its terminal branches. 

The median nerve is a mixed, but preponderantly 
motor, nerve. It supplies all the muscles on the anterior 
surface of the fore-arm, except the flexor carpi ulnaris 
and a portion of flexor profundus digitorum; it also 
innervates the muscles of the thenar eminence, with the 
exception of adductor transverses, adductor obliquus, 
and of the deep head of flexor brevis pollicis. The first 
two lumbricals also receive their motor fibers from this 
nerve. The sensory distribution comprises the greater 
part of the palm of the hand, and the anterior surfaces 
of the thumb, index and middle fingers, and the radial 
side of the fourth. On the dorsal surface the area of the 
median comprises the second and third phalanges of the 
index and middle fingers, and a portion of the fourth 
finger. It also sends a branch to the anterior part of the 
elbow-joint, the interosseous membrane, the periosteum, 
and the medullary canals of radius and ulna. 

In the arm the median nerve only gives off an anasto- 
motic branch to the musculo-cutaneous nerve. It only 
starts dividing at the antecubital space. 

1. Palmar branch. 

2. Digital branches. 

3. Muscular branches. 

4. Anterior interosseous nerve. 

(a) Branches to flexor longus pollicis and flexor 
profundus digitorum. 

(b) Several branches to the interosseous mem- 
brane. 



Brachial Plexus. 631 

1. Palmar Branch is given off at the beginning of 
the lower third of the forearm. It passes externally to 
the median nerve between the tendons, and then through 
the deep fascia to the skin. Below the transverse carpal 
(anterior annular) ligament it divides into several 
branches, which end in the thenar eminence and the 
palm of the hand. 

2. Digital Branches. — These are the four terminal 
branches. The first one, the smallest of the four, arches 
outwards, supplying flexor brevis pollicis, opponeus, and 
abductor brevis. It then splits into two branches, which 
run along the radial and the ulnar border respectively 
of the thumb, the outer one giving off the branch to the 
first lumbrical. The second digital branch supplies the 
cleft between thumb and index, and ends along the 
radial border of the index. The third digital branch 
gives off a branch to the second lumbrical, and splits 
into a branch for the ulnar side of the index and a branch 
for the radial side of the third finger. The fourth digital 
branch communicates by an anastomotic branch with 
the ulnar nerve, and divides into a branch for the ulnar 
side of the third and one for the radial side of the fourth 
finger. 

3. Muscular Branches. — Within the space men- 
tioned three are given off: To pronator radii teres, to 
palmaris longus and flexor carpi radialis, and to flexor 
sublimis digitorum. This last muscle receives two more 
fibers in the forearm. 

4. Anterior Interosseous Nerve arises from the 
median at the level of the origin of the anterior interosse- 
ous artery, and runs downwards along the outer side of 
this vessel to the pronator quadratus. Its branches are: 

(a) Branches to flexor longus pollicis and flexor pro- 
fundus digitorum. 

(b) Several branches to the interosseous membrane, 



632 Ramification of Nerves. 

which send filaments into the nutrient foramina of 
radius and ulna, and to the periostia of these bones. 

3. Circumflex Nerve, one of the terminal branches 
of the middle secondary trunk. It winds with the 
posterior circumflex artery around the surgical neck of 
the humerus, passing between teres major, minor, long 
head of triceps, and humerus. It ends in the deltoid. 

In its course it gives off the following branches: 

(a) Articular branches. 

(b) A cutaneous branch. 

(c) A branch to teres minor. 

(a) Articular branches to the anterior and posterior 
surfaces of the shoulder-joint. 

(b) A cutaneous branch, which either pierces the 
posterior fibers of the deltoid or passes between it and 
the long head of triceps. It ramifies in the skin covering 
the posterior surface of these muscles. 

(c) A branch to teres minor. 

4. Nerve to Subclavius. — Coming from the fifth 
and sixth cervical nerves, it passes in front of the plexus 
to the scalene tubercle on the first rib, where it divides 
into two branches, one going to the subclavius muscle, 
the other joining the phrenic nerve. 

5. Musculo-spiral Nerve. — This is the largest of 
all the nerves derived from the brachial plexus. It 
comes from the middle secondary trunk, and represents, 
with the circumflex nerve, the posterior tertiary trunk. 
In the axilla the musculo-spiral nerve passes behind 
the axillary artery, internally to the circumflex nerve. 
It then crosses the tendons of teres major and latissimus 
dorsi, and thus gets on to the outer head of triceps. 
Between this head and the inner head it passes back- 
wards and outwards with the superior profunda artery 
to the musculo-spiral groove. It enters this groove, and 
passes in it around the posterior circumference of the 
shaft of the humerus. After this spiral-shaped course it 



Brachial Plexus. 633 

runs between brachialis anticus, and brachio-radialis 
(supinator longus) on the anterior surface of the limb, 
where it appears internally to the outer condyle. Here 
it divides into a superficial branch, the radial nerve, and 
a deep one, the posterior interosseous nerve. 

The musculo-spiral nerve is, like the median and ulnar 
nerves, a mixed nerve. Contrary to the former, it gives 
off numerous branches in the arm, which are both motor 
and sensory. The motor distribution of this nerve com- 
prises the three heads of triceps, brachialis anticus, 
anconeus, all the muscles on the extensor surface of the 
forearm, including brachio radialis — i. e., supinator brevis, 
extensor carpi radialis brevior and longior, extensor carpi 
ulnaris, extensor communis digitorum, extensor minimi 
digit, extensor indicis, extensor primi internodii, extensor 
secundi internodii, and extensor ossis metacarpi pollicis. 
Its sensory area extends over the skin covering the dorsal 
surfaces of forearm and hand and a small portion of the 
arm. This latter area corresponds to the skin covering 
the brachialis anticus; it is limited above by the posterior 
border of the deltoid, internally by the outer head of 
triceps, and anteriorly by the outer border of biceps. 

In the forearm, the inner boundary of its cutaneous 
distribution corresponds to a line extending along the 
extensor carpi ulnaris to the ulnar styloid process, and 
then bending with a marked inward convexity to the 
middle line of the dorsal surface of the middle finger. 
The outer boundary corresponds to the outer border of 
extensor carpi radialis longior, and then passes across the 
styloid process of the radius to the thenar eminence, and 
over the palmar surface of the latter to the metacarpo- 
phalangeal joint of the thumb. The terminal phalanges 
of thumb, index, and middle fingers are, as already men- 
tioned, innervated by the median nerve. 

The branches of the musculo-spiral nerve are: 

1. Radial nerve. 



634 Ramification of Nerves. 

2. Muscular branches to the triceps. 

3. Lower cutaneous branch. 

4. Posterior interosseous nerve. 

5. Upper cutaneous branch of musculo-spiral nerve. 

1. Radial Nerve and the smaller, sensory, terminal 
branch. It follows at first the outer side of the radial 
artery, leaves it at the middle third of the forearm, 
passes backwards and outwards behind the tendon of 
brachio-radialis, and pierces the deep fascia of the extensor 
surface of the forearm. It crosses inwards over the 
styloid process of the radius, and divides into four or 
five terminal branches. The first branch furnishes the 
nervus dorsalis pollicis radialis. The second branch 
furnishes the nervus dorsalis pollicis ulnaris; the third, 
the nervus dorsalis indicis radialis; and the fourth, the 
nervus dorsalis indicis ulnaris and the nervus dorsalis 
digito medii radialis. The fifth branch communicates 
with the most external branch of the dorsal branch of the 
ulnar nerve, thus forming the nervus dorsalis medii 
digiti ulnaris. 

2. Muscular Branches to the triceps, one branch 
to each head. They are given off below the tendon of 
latissimus dorsi. The first branch accompanies for a 
certain distance the ulnar nerve, supplies the elbow- 
joint, and ends in the middle head. 

3. Lower Cutaneous Branch. — This is a pretty 
large branch which arises within the musculo-spiral 
groove. It passes between middle head of triceps and 
brachio-radialis, pierces the deep fascia and becomes 
subcutaneous between olecranon and external condyle. 
It supplies the skin over the extensor surface of the 
forearm. 

Muscular Branches to brachialis anticus, brachio- 
radialis, and extensor carpi radialis longior. They are 
given off where the musculo-spiral nerve leaves its groove 
and passes on to the anterior surface of the limb. 



Brachial Plexus. 635 

4. Posterior Interosseous Nerve, the larger, chiefly 
motor, terminal branch of the musculo-spiral nerve. It 
passes backward and downward through the supinator 
brevis, and then downward under the extensor communis 
digitorum. At the junction of the middle and lower third 
of the forearm it passes between extensor primi and 
extensor secundi internodii on to the posterior surface 
of the interosseous membrane, and runs downward on 
it, supplying it with sensation. It terminates in the 
carpal joints, a few fibers anastomosing with the dorsal 
branch of the ulnar nerve. In its course it supplies the 
following muscles: 

1. Extensor carpi radialis brevior. 

2. Supinator brevis. 

3. Extensor carpi ulnaris. 

4. Extensor communis digitorum. 
5.. Extensor ossis metacarpi pollicis. 

6. Extensor primi and secundi internodii. 
7." Extensor indicis. 

6. Long Thoracic Nerve (Bell's nerve) comes from 
fifth, sixth and seventh cervical nerves, passes downward 
and outward between scalenus medius and the meshes 
of the brachial plexus, and gives branches to each serra- 
tion of serratus magnus. Some describe the two nerves 
mentioned as "posterior thoracic nerves." 

7. Supra-scapular Nerve. — This is a large nerve 
derived from the first primary trunk of the brachial 
plexus. It runs along the lower belly of omo-hyoid to 
the supraspinous fossa of the scapula, and passes below 
the transverse ligament of the scapula to the infra- 
spinous fossa, It supplies supraspinatus, the posterior 
surface of the shoulder- joint capsule, and infraspinatus. 

8. Nerve to the Rhomboids, comes from anterior 
division of the fifth cervical nerve (in some cases from 
anterior division of fourth cervical), passes through 
scalenus medius downwards to the rhomboids and the 



636 Ramification of Nerves. 

upper serration of serratus posticus superior. It also 
sends filaments to levator anguli scapulae. 

9. Long Subscapular Nerve arises near the former, 
and passes between serratus magnus and subscapularis 
downwards to latissimus dorsi. 

10. First Subscapular Nerve leaves the middle 
secondary trunk of the plexus, and terminates in the 
subscapularis. 

11. Third Subscapular Nerve arises from the same 
trunk at a lower level, and supplies teres major and the 
lower portion of subscapularis. 

12. Musculo-cutaneous Nerve comes from the 
upper secondary trunk of the brachial plexus, just above 
the formation of the outer tertiary trunk. Situated at 
first antero-externally to the median nerve, it passes to 
the inner surface of coraco-brachialis, piercing that 
muscle. Its further course is between coraco-brachialis 
and biceps (nervus cutaneous anti-brachii lateralis) ; this 
is the cutaneous branch of the musculo-cutaneous. At 
the outer border of the tendon of biceps it pierces the 
deep fascia, and ramifies in the skin which covers the 
brachio-radialis (supinator longus). Its distribution 
extends as far as the inner portion of the thenar eminence. 
The musculo-cutaneous is a mixed nerve, supplying, 
apart from the cutaneous distribution, the large vessels 
of the arm, coraco-brachialis, brachialis anticus, and 
biceps. 

13. Internal Cutaneous Nerve has the same origin 
as the former. Situated at first behind and internally to 
the axillary vein, it passes forward and inward to it, 
and runs in front of the basilic vein. It pierces together 
with this vein the deep fascia of the arm, and then divides 
into two branches, a volar and an ulnar branch. It is a 
purely sensory nerve, which supplies the skin of the arm, 
covering biceps muscle. 



Brachial Plexus. 637 

(a) Volar branch. 

(b) Ulnar branch. 

(a) Volar Branch descends in front, and with the 
basilic vein, passes in the antecubital space behind the 
median-basilic vein, and ramifies in the skin covering 
the inner portion of the volar surface of the forearm as 
far as the external border of the flexor carpi radialis. 

(b) Ulnar Branch goes to the internal condyle, and 
supplies the skin over it and the flexor carpi ulnaris as 
far as the carpus. 

14. Lesser Internal Cutaneous Nerve.- — Arising 
from the lower secondary trunk, it passes through the 
axilla, behind, then internally to the axillary vein. Hav- 
ing pierced the deep fascia of the arm, it supplies the skin 
of the inner side of the arm and the inner condyle. In 
the axilla it receives a branch from the anterior division 
of the second dorsal nerve. It is a purely sensory nerve, 
which supplies the inner cutaneous surface of the arm, 
from axilla to inner condyle. Its area of distribution is 
limited anteriorly by the inner border of biceps; poste- 
riorly it extends on to the outer head of triceps practically 
as far as the middle line. 

15. External Anterior Thoracic Nerve comes 
from the uppermost secondary trunk, and passes in front 
of axillary artery and behind clavicle to pectoralis major. 

16. Internal Anterior Thoracic Nerve arises 
from the end of the lower primary trunk, emerges behind 
the axillary artery, anastomoses with the former nerve, 
and supplies with the bulk of its fibers, the pectoralis 
minor. The other fibers go to pectoralis major. 



CHAPTER VI. 
THORACIC NERVES. 

THE ramification of the thoracic nerves is more 
difficult to trace and understand because of the 
fact that the anterior branches, or those branches 
supplying the internal viscera, are distributed largely 
through the ganglia of the sympathetic system to the 
viscera they supply. The anterior branches of the spinal 
nerves join the gangliated cords and the great plexuses of 
the sympathetic; the spinal branches that join the two 
gangliated cords are not always distributed to the viscera 
immediately approximating the point where they join, 
nor to the viscera of that level. Many of the spinal fibers 
joining the ganglia of the cords pass upward or down- 
ward to be distributed to the viscera, organs, or parts 
above or below where they join the sympathetic ganglia. 

2. First Pair of Thoracic Nerves. — This pair of 
nerves pass out or extend from the neural canal between 
the pedicles of the first and second thoracic vertebras. 
They are affected by any abnormality of the articulation 
between the first and second thoracic vertebrae. This 
pair of nerves may be relieved by adjusting the second 
thoracic vertebra back or inferior, or by adjusting the 
first thoracic vertebra forward or superior, by the appli- 
cation of a thrust to its spinous process. 

They contribute branches to the following nerves: 
median, ulnar, internal anterior thoracic, internal cuta- 
neous, lesser internal cutaneous, long subscapular, and 
usually to the musculo-spiral. 

They supply the following muscles: pectoral muscles, 
erector spinse, serratus posticus, scaleni, latissimus dorsi, 
flexors of the fingers, levator costse, intercostal and deep 

muscles of the back and the spinal erector muscles. 

638 



PCSTc 


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HOT OF SPINAL NCRVE. 


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IOR {VENTRAL) ROOT 


Of SWIRL tlCRVC. 


SPIHAl GAVOLIO/t OS DO 


K« ROOT. 






•J/"'* 



1ATED CORD 




C P 


<M VV ».: CENTRAL 


PLACE 




WHITE MAUI. 






rOH S A. CENTRAL 


PLACE 


/V* {/fIN AC7/0*. 



SCHEME OF THE DISTRIBUTION OF THE 
THORACIC SPINAL NERVES. 



640 Ramification of Nerves. 

This pair of nerves also ramify the upper part of the 
lungs and of the heart, and are connected with the 
stellate ganglia by gray rami communicantes from the 
sympathetic system, and usually send white rami com- 
municantes to the stellate ganglia of the sympathetic; 
they in this way reach the vessels of the side of the head 
and affect dilatation of the pupils of the eyes and widening 
of the palpebral opening. 

3. The Stellate Ganglia. — The stellate or first 
thoracic ganglia of the sympathetic lie against the head 
of the first rib. They may be affected by pressure, and 
also by abnormal afferent impulses from interference 
with the first thoracic pair of nerves. 

They are important and contain cells of generation of 
accelerator impulses to the heart muscles, vasomotor fibers 
to the lungs, vasomotor fibers to the thyroid gland and 
inferior thyroid arteries, and vasoconstrictor fibers adjoin- 
ing the phrenic nerves. Vasomotor, pilomotor, and 
secretory and sebaceous fibers accompany the spinal 
nerves to the arms and hands; vasofibers also join the 
vertebral plexuses. 

Important spinal nerve fibers pass through these 
ganglia from the upper thoracic nerves on their way to 
the superior cervical ganglia, and through this channel 
the spinal fibers of the upper thoracic nerves reach and 
affect the head, face, and neck. 

The first thoracic or stellate ganglia, in connection 
with the other nerves composing the brachial plexuses, 
supply the upper extremities, and it is interference with 
this pair of nerves joining a stellate ganglion that is 
responsible for the claw hand, due to contracture of the 
muscles, and cause also the stunted growth of the finger- 
nails, and the waxy, clubby, distorted, and gouty finger- 
joints. It is an excitation of the trophic functions of 
these nerves that causes hypertrophy or overgrowth. 
Neuralgia and paralysis of the arm and lesions of the 



Thoracic Nerves. 641 

joints at the elbow and wrist are all caused by nerve 
lesions of this region. 

4. The Second Thoracic Nerves. — They pass out 
or extend from between the pedicles of the second and 
third thoracic vertebrae, and are affected by lesions of 
the articulation between these vertebras. Adjust the 
second spinous process superior or the third spinous 
process back or inferior for relief of interference with this 
pair of nerves. 

The second thoracic nerves ramify the intercostal 
muscles between the second and third ribs, the multifidus 
and erector spinas, and serratus posticus superior, etc. 
Lesions of this pair of nerves alter motor effects of volun- 
tary muscular action of the muscles supplied by it. 

They also alter the sensory effects and vasomotor 
effects on the heart and bronchi, vasomotor effects on 
lungs, vasoconstrictor effects on vessels of the eye, head, 
face, and neck, and motor effects on the pupil of the eye 
through the rami communicantes that they send to the 
superior cervical ganglia of the sympathetic system. 

These nerves connect with the second thoracic ganglia 
of the sympathetic by both gray and white rami com- 
municantes and with the first and third pair of thoracic 
nerves. 

5. Third Thoracic Nerves. — They pass from the 
neural canal between the pedicles of the third and fourth 
thoracic vertebrae and are interfered with by lesions of the 
articulation between these two vertebrae as they extend 
from the neural canal. 

These nerves may be relieved by throwing the spinous 
process of the third thoracic vertebra anterior or forward, 
or by applying a thrust to the spinous process of the 
fourth thoracic vertebra, throwing it inferior or back- 
ward. The patient in the adjustment of thoracic verte- 
brae usually lies upon a specially prepared table in a 
prone position. 



642 Ramificatibn of Nerves. 

These nerves supply the intercostal muscles in the 
interspace between the third and fourth ribs, and also 
supply the muscles of the spine in the immediate region 
of the spinous process of the third thoracic vertebra. 

These nerves have vasomotor effects on blood vessels 
of the head, face, neck, lungs, arms, chest, and affect the 
pupillo-dilator muscles, and supply vaso-motor fibers to 
the heart. 

They affect the secretions of the submaxillary and 
sweat glands of arms, neck, and chest; interference with 
them disturbs sensation in the third intercostal space 
and over the third spinous process, also a portion of the 
mammary glands and the third ribs. Pleurisy and disease 
of the upper lungs are relieved by removing all interfer- 
ence with this pair of nerves. 

They are connected with the third pair of ganglia of 
the sympathetic cords by both gray and white rami 
communicantes, and with the second and fourth pairs of 
thoracic nerves. 

All thoracic nerves furnish accelerator nerve impulses 
to the heart from the first downward to the fifth thoracic 
pair of nerves; pupillo-dilator fibers come from the same 
region. 

In the upper thoracic region of the spinal column are 
nerves to the nutrient, sweat, and emotional centers. 

6. Fourth Thoracic Nerves. — This pair make their 
exit through the foramina between the pedicles of the 
fourth and fifth thoracic vertebrae, and may be affected 
by lesions of their articulation with each other. They 
supply the intercostal and levator costae muscles and the 
deep muscles of the back. 

They connect with the fourth pair of thoracic ganglia 
of the sympathetic cords by gray and white rami com- 
municantes, and connect with the third and fifth thoracic 
pairs of nerves. 

This pair send nerve filaments to the heart ventricles 



Thoracic Nerves. 



643 



INT. BRA. (cutaneous] 
POST PRIM. DIVISION 



— .EXT BRA. (MUSCULAR) 



RECURRENT BRA. 




Plan of origin and distribution of a thoracic nerve, showing the manner 
of supply to the intercostal space, to the skin, and to musculature of the 
spinal column. 



644 Ramification of Nerves. 

and to the lungs; they supply the sweat glands of the 
arms and hands and the region of the nipple and mammary 
glands ; they affect the salivary glands and tonsils slightly, 
and supply the periosteum of the fourth ribs and the 
pleurae. 

We relieve contractions that interfere with these 
nerves and with the nutrition of the fourth segment of 
the spinal cord by the application of a thrust to the spin- 
ous process of either the fourth or fifth thoracic vertebra, 
throwing the fourth superior or the fifth inferior. 

7. Fifth Thoracic Nerves. — From the neural canal 
their exit is between the pedicles of the fifth and sixth 
thoracic vertebras. They supply the muscles, especially 
of the fifth intercostal spaces, and approximate muscles 
of the spinal column. 

They connect with the fourth and sixth thoracic 
nerves and the fifth thoracic pair of ganglia of the sympa- 
thetic system; through this union we get vasoconstrictor 
and secretory fibers to the arms, lungs, and pulmonary 
vessels, and the sweat glands and accelerator fibers to 
the heart. 

The white rami communicantes from these nerves 
join the fifth thoracic ganglion of the sympathetic and 
pass upward and affect the sebaceous glands of the face 
and the lachrymal glands; they furnish ramifying fibers 
which reach the gall-bladder, stomach and liver. 

They send fibers to the aortic plexus, cardiac plexus, 
pulmonary plexus, esophageal plexus, vasomotor nerves 
to the abdominal viscerae, and sensory and secretory and 
visceroinhibitory to the stomach. 

They also send filaments to the mammary glands, to 
the area of the nipple, the gall-bladder, liver, and spleen. 

They help form the great splanchnics through their 
union with the fifth sympathetic ganglia. 

They may be relieved by adjusting the sixth thoracic 



Thoracic Nerves. 645 

spinous process back or inferior, or by adjusting the 
fifth thoracic spinous process to the front or superior. 

The distribution of these nerves to the organs of the 
head is through a continuation of the white rami up the 
gangliated cord of the sympathetic, unchanged until they 
terminate in the cells of the superior ganglia of the sympa- 
thetic of the cervical region, in which they are changed 
and distributed. 

This is true of all the white rami communicantes 
from the spinal nerves, from the first or second thoracic 
down to the sixth pair. The fifth pair, or more often the 
sixth pair, of thoracic nerves is the dividing-point, since 
the upper five pair of rami communicantes from the 
spinal nerves are distributed upward, and below this 
point the white rami pass downward, with the exception 
of some fibers from the liver and kidney nerves, which 
affect the organs of the head and the skin of the upper 
extremities indirectly. 

8. The Sixth Thoracic Nerves. — This pair of 
nerves extend from the neural canal, passing through the 
foramina between the pedicles of the sixth and seventh 
thoracic vertebrae. 

This pair of nerves is of especial importance, because 
it is here we generally find the dividing-line between the 
two streams of the white rami communicantes as they 
are distributed to and through the ganglia of the sympa- 
thetic cords. 

It is an anatomical fact that the white rami communi- 
cantes from the upper five thoracic pair of nerves join 
the gangliated cords of the sympathetic and are dis- 
tributed partly directly through the ganglia where they 
join the sympathetic system, while the remaining fibers 
pass up the gangliated cord to be distributed to the 
regions above. 

Some of the fibers reach the superior cervical ganglia 



646 Ramification of Nerves. 

of the sympathetic system and are distributed through 
it to the twelve pairs of cranial nerves. 

The white rami communicantes from the sixth pair 
of spinal nerves and the spinal nerves below this point 
are distributed to the gangliated cord, where part of the 
fibers supply viscera directly through the ganglia where 
they join, while the other fibers pass downward in those 
cords and are distributed to the organs in relation below. 

It is for this reason that this pair of nerves, or, rather, 
this segment of the cord, is recognized as the central point 
of the spinal nervous system and the dividing-line between 
the two streams of distribution of the white rami from 
the spinal nerves. 

Any interference with this pair of nerves is decidedly 
more far-reaching in effects than is the interference with 
any other pair of the spinal nerves. 

These nerves send branches to the great cardiac plexus 
and the aortic and pulmonary plexuses of the thoracic 
cavity. 

This pair of nerves supply sensation to the integument 
over the sixth interspace between the ribs, and they send 
branches to the splanchnics, the aortic, and the solar 
plexuses of the abdominal cavity. These nerves connect 
directly with the sixth pair of thoracic ganglia of the 
sympathetic and also send communicating branches to 
the fifth and seventh thoracic pairs of nerves. 

The relief of these nerves produces a decided effect 
upon the sweat glands of the entire body, especially of 
the upper portion, in the region of the chest and arms. 

This pair of nerves supply viscero-inhibitor branches 
to the stomach and intestines, vasomotor branches to 
the abdominal blood vessels, and vasoconstrictor fibers 
to the portal veins; they also send filaments to the gall- 
bladder and bile-ducts. 

This pair of nerves exercise a decided control over the 



Thoracic Nerves. 647 

liver and supply nerve filaments to the mammary glands 
and also supply the diaphragm. 

There is no pair of nerves whose ramifications affect 
so many of the viscera of the trunk or have so general an 
effect upon the surface of the body as this pair of nerves. 

9. The Seventh Thoracic Nerves. — This pair of 
nerves make their exit one on either side from the neural 
canal through the foramina between the pedicles of the 
seventh and eighth thoracic vertebrae. 

These nerves join, by branching, with the sixth and 
eighth pairs of thoracic nerves, and also with the seventh 
thoracic ganglia of the ganglia ted cords of the sympathetic. 

They supply the muscles of the back around the 
seventh thoracic process, also the intercostal muscles of 
the seventh interspace between the ribs. The seventh 
nerve from the right side of the spinal column is dis- 
tributed principally to the liver. 

This pair of nerves also send vasomotor fibers, and 
trophic fibers are also supplied to the spleen, pancreas, 
lower part of the lun'gs, stomach, small intestines, and 
renal vessels, and also vasoconstrictor fibers to the vessels 
of the stomach and to the portal veins. 

They also supply sensory and secretory fibers to the 
stomach, liver, and the gall-bladder, and vasomotor 
filaments to the central portion of the liver. 

10. Eighth Pair of Thoracic Nerves. — These 
nerves extend from the neural canal through the inter- 
vertebral foramina between the pedicles of the eighth 
and ninth thoracic vertebrae. 

They send white rami communicantes to and receive 
gray rami communicantes from the eighth pair of ganglia 
of the gangliated cords of the sympathetic ; they also give 
off branches which join the seventh and ninth pairs of 
thoracic nerves upon both sides of the spinal column. 

These nerves supply the muscles of the abdomen and 
of the spine in the region of the eighth spinal process, and 



648 Ramification of Nerves. 

also the intercostal muscles in the eighth intercostal 
space. 

These nerves send filaments especially to the kidneys, 
pancreas, and spleen, small intestines, and supply vaso- 
constrictor filaments to the portal veins, gall-bladder, 
supra-renal capsules, and the upper part of the large 
intestines and the transverse colon; they also supply 
filaments to the small intestines and to the peritoneum. 

The nerve upon the right side of the eighth spinal 
segment sends filaments into the liver, and is responsible 
to a considerable extent for the function of this organ. 

11. The Ninth and Tenth Pairs of Thoracic 
Nerves. — These two pairs of nerves are given off from 
the ninth and tenth segments of the spinal cord and 
extend through the intervertebral foramina below the 
pedicles of the ninth and tenth thoracic vertebrae, respec- 
tively. 

These nerves supply the muscles of the spinal column 
of their own regions and supply the rectus abdominis 
muscles, both external and internal, the transversalis, 
and the erector and multifidus spinae; they also supply 
the integument, both above and below the umbilicus. 

These pairs of nerves each give off branches to the 
pairs of nerves above and below each of them and to 
each other, and also send white rami to the ninth and 
tenth thoracic ganglia of the sympathetic cords, and 
receive gray rami from the same ganglia. 

These nerves furnish part of the nerve supply to the 
aorta, kidneys, ureters, arid adrenals, and also fibers to 
the pancreas, spleen, liver, and stomach. 

We also find fibers from these nerves distributed to 
the testes or, in the case of females, to the ovaries and 
the fundus of the uterus, also to some of the convolu- 
tions of the small intestines and peritoneum, and to part 
of the large intestines. 

Effects of impingement of these pairs of nerves, 
especially the tenth, affect the diaphragm and lower 



Thoracic Nerves. 649 

part of the lungs, also the eyelids and the tissues around 
the eyeballs and the muscles of the equilibrium of the 
eyes; and all nerves above the tenth pair affect the 
secretory action of the skin above to the upper extremities 
and the head and upper part of the trunk, while the 
nerves below this pair control the secretions of the skin 
to all parts below the tenth pair of nerves — the "central 
place" for skin-action. The pairs of nerves of the thoracic 
region above the tenth pair all produce pilomotor effects 
on the integument of the upper part of the trunk, of the 
upper extremities, and of the head, while the tenth pair 
and all pairs below produce pilomotor effects upon the 
lower extremities; hence this pair of nerves are "central 
place" for skin action. 

12. Eleventh and Twelfth Pairs of Thoracic 
Nerves. — These nerves, coming from the eleventh and 
twelfth segments of the spinal cord, pass from the spine 
below the eleventh and twelfth thoracic vertebrae, as 
described of the ninth and tenth pairs of nerves above. 

They join their corresponding thoracic ganglia of the 
sympathetic system and the thoracic spinal nerves both 
above and below them, and also join each other by 
communicating branches. 

They especially ramify and supply vasomotor, trophic, 
and secretory fibers to the kidneys, aorta, pelvic viscera, 
and lower abdominal viscera. 

These nerves also supply fibers to the muscles of the 
rectum, bladder, vas deferens, and uterus, the sweat and 
sebaceous glands of the lower part of the body, and to 
the lower extremities. 

These nerves contribute fibers to the lesser splanchnic 
plexuses, which are formed principally from the twelfth 
pair of thoracic nerves and their corresponding ganglia 
of the sympathetic cords. 

A relief of these nerves, especially of the twelfth pair 
in connection with the sixth pair of thoracic nerves, is 
almost a specific for typhoid fever, 



CHAPTER VII. 
LUMBAR NERVES. 

THE vertebrae of the lumbar region are the largest 
of the movable vertebrae. Their bodies are 
kidney-shaped, the transverse diameters being 
greater than the antero-posterior. 

The notches in the pedicles are deeper than those in 
the pedicles of the thoracic vertebrae, and this makes the 
intervertebral foramina larger than those of the thoracic 
region. 

The spinous processes are short, large, and rectangular, 
and point outward in nearly a horizontal direction. 

Their transverse processes are usually longer and 
more slender; consequently they are not as strong as 
those of the thoracic vertebrae. 

The intervertebral discs are quite thick between the 
vertebrae of the lumbar region; they are slightly thicker 
in front than posteriorly; as also the bodies of the ver- 
tebrae are deepest in front; especially is this true of the 
fifth lumbar vertebra, which is quite wedge-shaped. 

The discs in the lumbar region are particularly liable 
to compression on account of the strains and the super- 
imposed weight of the body, the trunk resting wholly 
upon them. 

Any curvature of the spinal column depends more on 
the thickness and elasticity of the intervertebral discs 
than on the size or shape of the bodies of the vertebrae. 

The thickness of the intervertebral discs depends upon 
the contractured condition of the ligaments which bind 
and approximate the lumbar vertebrae together. 

The ligaments of this region are thick and strong, 
much more so than are those of the thoracic or cervical 
regions of the spine. 

650 



Lumbar Nerves. 651 

They are also more subject to irritation and injury, 
which will cause them to shorten and thicken, and this 
shortening of these ligaments will approximate the 
vertebrae and thus cause a narrowing of the intervertebral 
foramina, which will interfere with the transmission of 
veins, arteries, lymphatics, and nerves. 

The lumbar nerves are the largest nerves given off 
from the spinal cord, and the anterior branches increase 
in size from above downward, or from the first to the 
fifth pair. 

Each pair of lumbar nerves sends branches to the 
pair of nerves immediately above and below them, and 
they communicate with the sympathetic gangliated cords, 
by sending to them white rami communicantes and also 
by receiving gray rami communicantes from the sympa- 
thetic, which branches join the lumbar nerves and are 
distributed with them. 

Branches from the twelfth thoracic nerves and from 
the first three pairs of lumbar nerves, together with a 
large portion of the fourth lumbar, form the lumbar 
plexuses. 

Part of the fourth lumbar pair of nerves, together 
with the fifth pair, join the sacral nerves and help in 
the formation of the sacral plexus. 

The lumbar nerves are very important, for the reason 
that the largest and longest nerve trunks in the body are 
made up of the lumbar and sacral nerves. 

These nerves supply the pelvic cavity largely and also 
the whole of the lower extremities. Nerve fibers extend 
from the lumbar region to the ends of the toes. 

Contraction of ligaments and muscles and the conse- 
quent approximation of the lumbar vertebrae, causing 
interference with the nerve supply to the lower extremi- 
ties, is largely responsible for rheumatic conditions — 
lumbago, sciatica, and practically all ailments of the 
lower extremities, and of interference with the power of 



652 Ramification of Nerves. 

locomotion, except where these troubles come from the 
nerve-centers in the brain which control the action of 
the lower limbs. The sacral nerves are of less importance 
to us from the fact that they extend from the neural canal 
through solid bony foramina that cannot be affected by 
contraction of ligaments. 

THE FIRST PAIR OF LUMBAR NERVES. 

r I ^HESE nerves extend or pass out from the neural 
-*- canal between the pedicles of the first and second 
lumbar vertebrae ; they supply part of the muscles of the 
lower abdomen and of the lower thoracic region and also 
furnish filaments to the first lumbar vertebra and its 
ligaments. 

These nerves give off branches and help to form the 
ilio-inguinal, ilio-hypogastric, and also help in the forma- 
tion of the geni to-crural, besides sending branches to 
the nerves below and above and to the first lumbar 
ganglia of the sympathetic. 

These nerves supply sensation to a part of the peri- 
toneum, to the integument over the trochanter and just 
below, and to the upper and inner aspects of the thighs, 
and also to the scrotum, and to part of the external 
genitalia and to the gluteal regions. 

They also furnish vasomotor, trophic, secretory, and 
sensory fibers, carrying impulses to the lower colon, 
uterus, bladder, ureters, epididymis, Fallopian tubes, 
vas deferens, to the muscular walls of the rectum, to the 
vessels of the abdomen, to the lower limbs, and to the 
sweat and sebaceous glands of the integument of this 
region and the lower extremities. 

The first pair of lumbar nerves usually have more 
control over the bladder than any other pair of nerves 
and seem to exercise the principal controlling influence 
over the health and action of this organ, and especially 



Lumbar Nerves. 653 

supply tone to the sphincter muscles of the bladder in 
connection with the second pair of lumbar nerves. 

If a lesion affecting these nerves tends to impair their 
activity or excitability, there will be, as a result, impaired 
transmission of impulse, causing a relaxed or paralytic 
condition of the bladder and of the sphincter muscles 
thereof; while on the other hand, if the lesion is irrita- 
tive, the patient will experience a condition called "vesical 
tenesmus," and may be unable to relax the sphincter 
muscles so as to easily perform the act of micturition. 

THE SECOND PAIR OF LUMBAR NERVES. 

T^HE second lumbar vertebra is a typical one. Its 
■*■ most common variation from its normal position 
or relation is that of undue approximation, which is 
caused by a contraction of the ligamentous and muscular 
bands that bind it to its adjacent vertebrae. 

Any undue approximation of this vertebra to the one 
immediately below it will cause a narrowing of one or 
both of the second lumbar intervertebral foramina and 
a consequent interference with one or both of the second 
pair of lumbar nerves. This will also interfere with the 
blood vessels and lymphatics as well as the nerves which 
they accompany. 

Lesions of the second lumbar nerves will also affeftt 
the ligaments and muscles that cause the undue approxi- 
mation, sometimes causing contraction remaindejg'i]$i&t 
will continue the undue approximation. It is &feoiM§ll 
to remember that any lesion of the nerve that^j$${jd&cite 
or irritate these nerves will cause undue conij^tijmitejl 
also hyperesthesia and pain. jxi vjoanea bus 

If a paralytic condition is induced b§brifeflpng!@Bleii6, 
causing an impairment of the transnf&^sMn80#i^tebv44H;l 
force, there will be a relaxed condatffiW#baJ# MlMa^leort 



654 Ramification of Nerves. 

all of the organs supplied by these nerves, causing them 
to be in an atonic condition. 

The second pair of lumbar nerves either chiefly or 
partly form the geni to-crural, antero-crural, external 
cutaneous, recurrent meningeal and obturator nerves, 
and they also send branches to the aortic and hypogastric 
plexuses. 

The geni to-crural nerves, soon after passing from the 
intervertebral foramina, pass into and through the psoas 
muscles and fascia upon either side, and they then divide 
into the genital and crural nerves. 

The genital branches supply the inguinal canals. 
They each enter through the internal abdominal ring 
and accompany the spermatic cords on their way through 
the inguinal canals. 

Filaments from these nerves supply the iliac arteries, 
the cremasteric muscles, and the integument of the 
scrotum and of the thigh in that immediate region. In 
females these nerves supply the round ligaments. 

In case of an interference, causing a paralytic condi- 
tion of these nerves, the skin of the scrotum will not 
respond to any irritation, and there is a relaxed and 
dependent condition of the testicles. 

The inguinal canals, one or both, will be in a relaxed 
condition, owing to the lack of tonicity of the muscular 
walls, which condition permits protrusion of a segment of 
the intestines, or hernia. 

The cremasteric reflex will be lessened or will be 
entirely absent, owing to the amount of interference 
with the nerve supply. 

Through the lumbar and pelvic plexuses the second 
pair of lumbar nerves send vasomotor, trophic, secretory, 
and sensory impulses to the lower colon, uterus, bladder, 
ureters, epididymis, Fallopian tubes, external genitalia, 
vas deferens, to the muscular walls of the rectum, to the 
vessels of the abdomen and the lower limbs, and to the 



Lumbar Nerves. . 655 

sweat and sebaceous glands of the integument of the 
lower extremities. 

This segment of the spinal cord, from whence come 
this pair of nerves, is said to contain the centers for 
defecation, parturition, and micturition. 

Both defecation and micturition are reflex phenomena, 
hence there must be a stimulus and normal reflex excita- 
bility of the nerve fibers without any interference with 
the normal action or excitability thereof. 

In case of micturition, the stimulus is the accumula- 
tion of urine in the bladder, until it reaches a certain 
amount, causing pressure to a certain degree. This 
condition will act as a stimulus, which, through excitation 
of the nerve action, will cause contraction of the bladder 
walls and at the same time a relaxation of the vesical 
sphincters. 

In the lower bowel and in the rectum the fecal matter 
acts as a stimulus, causing reflexly, but involuntarily, 
peristaltic movements of the lower bowels. 

Parturition, to be normal, must be governed by a 
normal supply of nerve impulse. A depreciation of the 
excitability of the nerve supply is responsible for "inertia 
uteri" in proportion to the lessened excitability of the 
nerve supply. The process of parturition is a reflex 
phenomenon. 

The menstrual function is also affected by the nerve 
supply from this segment of the cord. From our experi- 
ence in relieving nerves involved in menstrual disorders, 
we are convinced that the second pair of lumbar nerves 
also play an important part in the control of the functions 
of the uterus. 

Lumbago quite frequently comes as a result of 
impingement of the second pair of lumbar nerves. The 
ordinary stitch in the back is a result of nerve-impinge- 
ment, and also the tenderness of the muscles and liga- 
ments, and the hyperesthesia and pain are direct results 



656 Ramification of Nerves. 

of the condition of the nerves; especially is this true if 
the nerve lesion causes over-excitability of the nerve. On 
the other hand, there is weakening of the nerve tone; 
the spinal column will be weakened, due to the lack of 
tonicity of the muscles and ligaments, and this will some- 
times cause curvature, or may simply cause aches or 
weakness of the back. 

The spinal cord may be impinged in the neural canal 
by a subluxation of this vertebra, and this will affect the 
function of the segments below and an impairment of all 
nerves derived therefrom. 

The second pair of lumbar nerves in connection with 
the first pair possess the vasoconstrictor control over the 
bowels and other abdominal viscera. 

By an adjustment to relieve the second pair of lumbar 
nerves we control dysentery, diarrhea, and overcome 
relaxed and prolapsed conditions of the bowels that favor 
hernia. 

The second pair of lumbar nerves supply the appendix 
and through them we control appendicitis. This we have 
noticed in clinical experience. In appendicitis, we always 
find the second pair of lumbar nerves tender and by an 
adjustment we relieve them. We have never failed to 
relieve acute appendicitis with one adjustment. 

As the second pair of nerves supply the inguinal canal 
they are responsible for the integrity of these passages, 
and any interference with them will permit lesion such 
as hernia, and adjustment to remove interference with 
this pair of nerves often relieves hernia. 

These nerves relieve hernia in two ways: 

First, by giving tonicity to the supporting tissues of 
the bowels; and 

Second, by vasomotor influence, contracting the 
musculature of the inguinal canal. 

The second pair of lumbar nerves exert the most 
decided stimulating influence upon the erectile tissues of 



Lumbar Nerves. 657 

the genital organs and stimulation of them gives strength 
to their functional activity. 

THIRD LUMBAR NERVES. 

HP HE third lumbar vertebra is large compared with its 
-■- fellows, and its prominence for the attachment of 
muscles is well developed. Under normal conditions, its 
movements are comparatively great, but contraction of 
the ligaments from irritation or from disease will impair 
the movements. 

The transverse processes of this vertebra are longer 
than those of the vertebrae above. There may be an 
abnormal approximation of this vertebra with either the 
second above or the fourth below, but more frequently 
only one articulation is involved. 

The ligaments at this point are larger and stronger 
than those of the vertebrae above and the facets are also 
deeper. This portion of the spinal column is built 
stronger, because it is exposed to more strains than the 
other portions of the spine and also is subject to the 
superimposed weight of the body. 

A contractured condition of the ligaments, because 
of their thickness and strength in this part of the body, 
is more potent in the production of lesions of the articula- 
tions of this vertebra, which is caused by their contrac- 
tion. Ligaments that are injured, bruised, or in any way 
irritated, become tender, congested, and thickened and 
contractured, approximating the vertebrae and thinning 
the intervertebral disc, thus narrowing the intervertebral 
foramina. 

As a result of an excitation of the nerves, the muscles 
are likewise contractured, and consequently they aid in 
overcoming the proper relation of the vertebrae to which 
they are attached. Probably the most important muscles, 
causing a contraction in the lumbar region, that are 



658 Ramification of Nerves. 

affected by irritation of the third pair of lumbar nerves 
are the multifidus spinas, erector spinas, and the psoas 
magnus. 

The effect of irritative lesions of the third lumbar 
nerves, because of impingement through muscular con- 
traction, depends upon which muscle is most affected. 

The multifidus spinas when contracted will tend to 
draw the spine to one side. If the erector spinas are 
contracted, the spine will be curved toward the affected 
side. A contraction of the psoas muscles tends to flex 
the thigh upon the abdomen. 

The contraction of all these muscles will contract the 
intervertebral discs while approximating the vertebrae 
and tend to make the lumbar portion stiff; and the 
mobility, veins, arteries, and lymphatics may also be 
disturbed by narrowing of the intervertebral foramina, 
as described above. 

As a result of lesions of this pair of nerves, the func- 
tion of several nerves may be impaired. The anterior 
crural nerve is formed principally from the third pair of 
nerves and is derived from the third lumbar segment, 
but it also receives fibers from the fourth pair of lumbar 
nerves below and from the second pair above, and some- 
times receives fibers from the first lumbar nerves. 

Lesions of the third lumbar nerves will also affect 
the long saphenous; also the obturator nerve supply 
comes from this segment. The external cutaneous nerve 
is another branch of the third lumbar. 

Branches from the third lumbar also join the aortic 
and hypogastric plexuses; branches join the gangliated 
cord of the sympathetic, so that this portion of the 
sympathetic may also become affected through inter- 
ference with the third lumbar nerves. 

The hemorrhoidal plexus, that supplies the rectum 
with motor, vasomotor, secretory, and sensory impulses, 
may also be deranged by interference with the third pair 



Lumbar Nerves. 659 

of lumbar nerves; as a result of this, we may have 
hemorrhoids, diarrhea, proctitis, rectal ulcers, and may 
have spermatorrhea. The testicles and the uterine and 
prostatic plexuses are also affected by lesions of the third 
lumbar nerves. 

Many pathological conditions of the uterus and 
prostate glands are the sequence of lesions of the third 
lumbar nerves. Sometimes considerable subluxations 
occur and of such magnitude as to cause pressure upon 
the cauda equina. In such cases paralysis may follow, 
and derangement of the organs supplied below this point 
is inevitable. 

There will be affections of the bowels and bladder and 
paralysis of the vesical sphincter, accompanied by a 
dribbling of the urine. The lower bowel may be paralyzed, 
causing obstinate constipation. The sexual organs will 
also be affected, causing a loss of tonicity, and impotence. 

Lesions of the third lumbar nerves are usually asso- 
ciated with aches, lumbago, sciatic rheumatism, and a 
general disturbance of the pelvic organs and the lower 
extremities. The third lumbar nerves especially affect 
and control the ovaries and testicles. 



THE FOURTH PAIR OF LUMBAR NERVES. 

HP HE body of the fourth lumbar vertebra is larger than 
A any of those above it; it is decidedly kidney-shaped, 
the transverse diameter being much greater than the 
anteroposterior. 

The transverse processes vary considerably in different 
cases; in some they are quite long and slender, while in 
other cases they may be short and rudimentary. 

The spinous process is large and strong and in some 
cases, especially in very strong spines, they have articular 
facets on the tip of the process upon the upper and lower 



660 Ramification of Nerves. 

borders where they come in contact with the spinous 
processes of the adjacent vertebrae. 

The cartilages below this vertebra and those adjacent 
are quite thick and also very elastic as compared with 
the other intervertebral discs. As age advances, or as a 
result of the contraction of the ligaments approximating 
this to adjacent vertebrae, the intervertebral discs become 
thinned below this vertebra. The ilio-lumbar ligaments 
also attach to the transverse processes and their contrac- 
tion may tend to cause subluxation of the fourth vertebra. 

There is normally a decided mobility of the articula- 
tions of this vertebra. While the facets are deep and the 
articulations strong, rendering complete subluxation 
almost impossible, yet minor lesions of the normal 
approximation of this vertebra with adjacent ones are 
quite common, on account of sprains caused by move- 
ments of the articulations to a sufficient extent to strain 
or injure the ligaments. 

This injury to the ligaments may be caused by a 
misstep, torsion, rotation, extension, or any extreme or 
excessive movement that will rupture some of the fibers 
of the spinal ligaments, which will cause them to become 
tender and to shorten and thicken, and the natural 
result is an undue approximation of the vertebrae and a 
narrowing of the intervertebral foramina, which may 
occur on one or both sides. 

The fourth pair of lumbar nerves make their exit 
from the neural canal and lumbar region through the 
intervertebral foramina, formed by notches in the adja- 
cent sides of the pedicles of the fourth and fifth lumbar 
vertebrae. 

They ramify and supply motor, trophic, thermic, 
sensory, and vasomotor functions to the organs which 
they ramify; they connect with the nerves, both above 
and below, in the formation of nerves which ramify the 
pelvic cavity and the lower extremities. 



Lumbar Nerves. 661 

The large part of these nerves unite with the fifth 
pair of lumbar nerves and sacral nerves to form the 
great sciatic nerves. 

This pair of nerves supply chiefly the muscles to the 
anterior and inner side of the thigh; also the gluteus 
muscles, more especially the medius and minimus muscles 
of the gluteous region. 

These nerves also supply the quadra tus femoris; 
they also supply some of their fibers to the muscles of 
the back of the body and to the back of the lower limbs. 

Some of the principal organs that are chiefly supplied 
by this pair of nerves are as follows: the uterus, fallopian 
tubes, vagina, prostate gland, and vas deferens; the 
above organs being supplied mostly through the pelvic 
ganglion of the sympathetic. The seminal vesicles and 
the rectum also receive filaments from this pair of nerves. 
Fibers also supply the knee-joints, hip-joints, and ankle- 
joints, and possibly most of the articulations of the bones 
of the feet come from the fourth pair of lumbar nerves. 

The genital centers of the spinal cord are found in the 
fourth segment of the lumbar portion of the cord. These 
nerves principally control the circulation of the blood in 
the uterus and the action of the lower bowels and affect 
the erectile tissues of the genital organs. 

As a result of interference with this pair of nerves, 
you may have disturbance of the menstrual flow, and if 
the lesion is irritative in effect, you may have a hyperes- 
thetic condition and painful menstruation; also, you may 
have contraction of the muscles of the gluteal region and 
of the back of the thigh and of the calves of the leg; and 
also may have pain in the hip, knee, or ankle-joints. 

Impingement of these nerves also causes derangement 
of the functions of the genital organs, or inhibition of the 
normal transmission of impulse may cause weakness, 
impotence, sterility, barrenness, also constipation and 
hemorrhoids; and in the case of young persons there 



662 Ramification of Nerves. 

may be improper development of the external genitalia 
and spermatorrhea may occur. 

The posterior subluxation is very rare, but may be 
caused by straining or lifting while in a condition of 
extreme flexion. 



THE FIFTH LUMBAR VERTEBRA AND NERVES. 

/ T S HE forward subluxation of the fifth lumbar is the 
A natural result of the shape of its body and of the 
superimposed weight. 

The fifth lumbar nerves make their exit from the 
neural canal beneath the pedicles of the fifth lumbar 
vertebra. These nerves send branches to the fourth pair 
of lumbar nerves above and to the sacral nerves below, 
and also join the pelvic plexus and other terminal plexuses 
in relation with the pelvic organs. 

All the nerves which receive filaments from this pair 
of nerves may be affected by lesions of them. Some of 
the principal nerves receiving filaments from the fifth 
lumbar pair are the superior gluteal, inferior gluteal, and 
the nerves supplying some of the larger muscles and the 
great sciatic nerve. 

Some of the muscles that may be affected by lesions 
of this nerve are the erector and multifidus spinae, obtura- 
tor internus, and quadratus femoris; and as a result of 
impingement of this pair of nerves we may have inter- 
ference with the lower part of the large intestines, and 
especially rectal troubles, and also affections of the knee 
and ankle joints, and in extreme cases we have severe 
rheumatic conditions, and also paralysis of the lower 
extremities. 

Diagnosis of lesions of this vertebra are made by 
detecting tenderness over the spinous process and by 
tenderness over the intervertebral foramen, due to a 



Lumbar Nerves. 663 

tender condition of the nerves and by contraction or 
tenderness of the muscles in that immediate region, and 
by the approximation or lateral position indicated in the 
alignment of all the processes of this and adjacent 
vertebrae. 

The fifth lumbar vertebra is one of especial importance 
on account of the frequency of its subluxation. Between 
the fifth vertebra and the sacrum is an articulation that 
is weak from two or three considerations. 

First, the body of the fifth vertebra is quite wedge- 
shaped, owing to the excessive thickness of the front part 
of the vertebra over that of the posterior border of its 
body; second, because at this point of the spine the same 
condition exists as at the union between the first lumbar 
with the twelfth thoracic vertebra — namely, a movable 
vertebra articulating with a more or less immovable seg- 
ment; third, there is still another cause tending to pro- 
duce subluxations of the fifth lumbar, and that is, the 
superimposed weight of the body and the tendency of 
any force or jar that is applied to the upper part of the 
spine being transmitted to and expended upon the lower 
vertebra of the spinal column, or, rather, upon its articu- 
lation with the sacrum. 

These unfavorable conditions are, however, partly 
overcome by the extra strength and thickness of the 
lumbo-sacral ligaments and other ligaments that hold 
the fifth lumbar vertebra in apposition with the sacrum. 

The lesions of this lumbar may be anterior or posterior, 
or there may be slight torsion. 

Lumbar Plexus. — The short trunk of the anterior 
division of the first lumbar nerves, having given off twigs 
to quadratus lumborum, divides behind psoas major into 
two branches. The upper one is joined by a branch from 
the twelfth thoracic nerve. From the new nerve thus 
formed two new nerves are derived: ileo-inguinal and 
ileo-hypogastric. The lower one passed behind psoas 



664 Ramification of Nerves. 

and unites with the anterior division of the second lumbar 
nerve. This division is longer than the former one, and 
gives off a branch which is joined by a branch from the 
anterior division of the third lumbar nerve, and another 
one from the fourth lumbar anterior division. Thus the 
obturator nerve is formed. From the connection between 
first and second anterior divisions results the geni to-crural 
nerve. The rest of the anterior division of the second 
lumbar nerve partly joins the third anterior division, 
partly a branch from that division. This latter junction 
forms the external cutaneous nerve. 

The anterior division of the third lumbar nerve gives 
off a branch to the fourth lumbar anterior division, a 
branch to the obturator nerve, another to the external 
cutaneous nerve, and ends by joining the fourth anterior 
division after having received the communicating branch 
from the second division. 

The anterior division of the fourth lumbar nerve 
sends a branch to the fifth obturator nerve, and joins 
the two branches described of the third division to form 
the anterior crural nerve. 

The lumbar plexus lies in front of the transverse 
processes of the lumbar vertebrae, embedded partly in 
the psoas major, which is pierced by the greater part of 
its branches. 

This plexus supplies internal oblique, quadratus, 
lumborum, cremaster, and the muscles of the hip and 
thigh, with exception of those on the posterior aspect of 
that region. 

The sensory distribution comprises the skin of the 
loin, the external genitals, and the anterior aspect of the 
thigh. Here it is limited externally by the outer border 
of biceps and internally by the inner border of semi- 
tendinosus, thus reaching on to the posterior aspect of 
the limb. Below, the sensory area extends beyond the 
knee on to the antero-internal aspect of the leg as far 



Lumbar Plexuses. 665 

as the inner border of the foot. Its outer boundary is a 
line passing from the outer border of the patella along 
the outer border of tibialis anticus; its inner limit extends 
on the posterior aspect of the leg as far as the outer 
border of the tendo-achilles and the middle of the inner 
head of gastrocnemius. 

The branches of the lumbar plexus are: 

1 . Muscular branch. 

2. Obturator nerve. 

3. Ileo-inguinal nerve. 

4. Genito-crural nerve. 

5. Ileo-hypogastric nerve. 

6. External cutaneous nerve. 

7. Muscular branches to psoas. 

8. Anterior crural nerve. 

1. Muscular Branch to quadra tus lumborum, from 
anterior division of first lumbar nerve, passes through 
psoas and supplies the quadratus lumborum. 

2. Obturator Nerve. — This nerve arises from the 
second, third, and fourth lumbar nerves, as described 
above. It is formed within the psoas major, and emerges 
at its inner border. It passes behind the iliac vessels over 
the sacro-iliac joint to the obturator foramen, within 
which it lies above the obturator artery, and gives off a 
branch to obturator externus muscle and to the hip- 
joint. 

Having left the foramen, it divides immediately into 
its two terminal branches: 

(a) Anterior branch. 

(b) Posterior branch. 

(a) Anterior Branch passes over the upper border 
of obturator externus between adductor brevis and 
adductor longis, and then between longus and gracilis to 
the skin. It supplies the muscles mentioned, and ramifies 
in the skin covering the inner surface of the thigh. 

(b) Posterior Branch pierces obturator externus 



666 Ramification of Nerves. 

and goes to adductor magnus, supplying it. It also gives 
branches to the hip- joint, obturator externus, and 
adductor brevis. 

3. Ileo-inguinal Nerve, smaller than the former, 
takes a similar course. Having pierced the aponeurosis 
of the transversalis, it passes downward and inward along 
the inguinal canal, emerges at the superficial inguinal 
ring, and ramifies in the skin, covering the middle of 
the groin, the mons pubis, and scrotum or labia majora. 
Like the ileo-hypogastric nerve, it is a mixed nerve, 
sending a few branches to the oblique muscles. It fre- 
quently sends a cutaneous branch to the anterior surface 
of the thigh. 

4. Genito-crural Nerve arises, as explained above, 
from the anterior divisions of first and second lumbar 
nerves. It emerges between psoas and third lumbar 
vertebra, passes downwards and outwards on the muscle 
(internally to the tendon of psoas minor, if present), and 
divides at a variable distance from Poupart's ligament 
into its two terminal branches: 

(a) Genital branch. 

(b) Crural branch. 

(a) Genital Branch. — Its course is directed more 
inward. The nerve passes, crossing in front of the 
larger vessels, to the inguinal canal, below the spermatic 
cord or round ligament, and descends to the testicle or 
labia majora. Where it leaves the superficial inguinal 
ring it ramifies in the territory of the ilio-inguinal nerve; 
it ends by sending twigs to the Cremaster, Dartos or 
labia majora. 

(b) Crural Branch passes along the outer border 
of psoas, external to the genital branch. Above 
Poupart's ligament it splits into two or more branches, 
which pierce the transversalis fascia and fascia lata 
below Poupart's ligament, and become subcutaneous 



Lumbar Plexuses. 667 

externally to the saphenous opening. Their area does 
not extend as far as the middle of the thigh. 

5. Ileo-hypogastric Nerve is the upper terminal 
branch of the first anterior division. It emerges from the 
psoas, passes on to the anterior surface of quadratus 
lumborum, and runs obliquely downwards to the iliac 
crest. It now pierces the aponeurosis of trans versalis, 
and passes forwards between transversalis and internal 
oblique over the antero-superior spine. At the mid- 
point of Poupart's ligament it pierces internal oblique 
and aponeurosis of external oblique, and ends in the skin 
of the groin and mons pubis (hypogastric branch). In 
its course it gives fibers to internal and external oblique. 
Before reaching the antero-superior spine it gives off its 

Iliac Branch, which pierces the internal and external 
oblique muscles, and passes over the iliac crest to the 
outer portion of the skin covering the hip region. 

6. External Cutaneous Nerve is formed by the 
junction of branches from the anterior divisions of second 
and third lumbar nerves at the level of fourth lumbar 
vertebra. It emerges, either by piercing the psoas or at 
its outer border, below the fascia iliaca, and passes 
obliquely outwards and downwards over iliacus to the 
antero-superior spine. Below the latter it appears under 
Poupart's ligament, internally to sartorius, gives branches 
to the area supplied by the crural branch of genito- 
crural nerve, and divides into two branches, which pierce 
the superficial layer of the fascia lata, and thus become 
subcutaneous. The smaller, outer branch ramifies in 
the skin over the great trochanter; the larger, inner 
branch runs along the anterior border of vastus externus 
to the knee, supplying with many filaments the outer 
surface of the thigh. 

7. Muscular Branches to Psoas: two or three 
from the lower branch of anterior division of first lumbar 
nerve. 



668 Ramification of Nerves. 

8. Anterior Crural Nerve comes, as described 
above, from the anterior divisions of second, third, and 
fourth lumbar nerves. This is the largest nerve derived 
from the lumbar plexus. It emerges at the outer border 
of psoas, and passes behind the fascia iliaca in the furrow 
between the iliacus and the psoas portion of the ilio-psoas. 
It runs under Poupart's ligament, approaching gradually 
the large vessels. Below the ligament it lies to the outer 
side of the femoral artery, and splits soon into its terminal 
branches. Its branches are: 

1. Muscular branches to ilio-psoas. 

2. Muscular branches to pectineus, rectus femoris, 

vastus externus, crureus and vastus internus. 

3. Long saphenous nerve. 

4. Middle cutaneous nerve. 

5. Nerve to femoral artery. 

6. Internal cutaneous nerves. 

1. Muscular branches to ilio-psoas above Poupart's 
ligament. 

2. Muscular branches to pectineus, rectus femoris, 
vastus externus, crureus, and vastus internus. The first 
branch given off is the one to rectus femoris. The 
branches to the triceps extensor usually run for some 
distance in their muscles, and give filaments to the 
knee-joint. 

3. Long saphenous nerve. Covered by sartorius, it 
runs at first externally to the femoral artery, and then 
in Hunter's canal in front of that vessel. By piercing 
the anterior wall of the canal, it leaves the artery and 
passes under the deep fascia, between abductor magnus 
and internal vastus, to the inner surface of the knee. 
Here it pierces the fascia behind the tendon of sartorius, 
and follows the long saphenous vein along the internal 
surface of the leg to the inner border of the foot. Its 
branches are: 



Lumbar Plexuses. 669 

(a) Infra-patellar branches. 

(b) Cutaneous branches. 

(a) Infra-patellar branches, one or two, given off at 
the internal condyle; one perforating sartorius and 
supplying the skin over the patella, the other passing 
over that muscle to the skin below the knee. 

(b) Cutaneous branches given off in the leg, which 
ramify on its anterior and internal surfaces. 

4. Middle cutaneous nerve, one or two branches 
running along the posterior surface of sartorius, supplying 
it. They pierce that muscle, or wind round its inner 
border, and ramify in the skin covering the anterior 
aspect of the thigh. 

5. Nerve to femoral artery arises also above the 
ligament, and goes to the femoral artery. A branch 
passes with the profunda femoris artery to the nutrient 
foramen of the femus. 

6. Internal cutaneous nerves. Two or three nerves 
which pierce at various levels, externally to the saphe- 
nous vein, the fascia lata, and ramify in the skin on the 
anterior aspect of the thigh. 



PART SEVEN. 

SPONDYLOTHERAPY METHODS. 

CHAPTER I. 
NERVE SUPPLY AXD TREATMENT. 

IN this chapter we wish to enumerate the principal 
regions or zones of the human organism, and to 
briefly indicate the nerve supply to the special zones 
that are affected in case of disease, and the treatment 
that should be given to remove all interference with the 
nerve supply and thus restore the normal functional 
activity and health to the diseased areas. 

We will not enumerate the diseases to which the 
different zones are liable, nor do we find this necessary 
since the function of any zone or part is dependent upon 
the integrity of the nerve supply, hence removing inter- 
ference with the integrity of nerves is effective against all 
disease. 

Normal nerve supply is necessary to normal function, 
and normal impulse can never be had except when all 
interference with nerve supply has been removed. Nerves 
are subject to different amounts and quantities of inter- 
ference and organs or parts of the body are liable to 
different forms of disease. 

There are different exciting causes of disease which 
in a great measure account for the different forms and 
manifestations thereof. All forms of abnormal function 
or disease are permitted or caused by an interference and 
deviation from the normal condition of the nerve supply. 
We fully believe that the restoration of normal nerve 
supply will be necessary to remove the permitting con- 
dition or predisposing as well as often the direct exciting 
cause of deranged function or disease. 

671 



672 Spondylotherapy Methods. 

In this chapter it is our intention to call to mind 
the principal regions or zones of the body, and mention 
the segments of the spine that should be treated by 
spondylotherapy methods in order to remove interfer- 
ence with the nerve supply to the different zones, and to 
stimulate them to sufficient functional activity to cause 
the restoration of health. 

Diseases of the Ankles. — The sciatic nerves sup- 
ply the ankles and usually that portion of the sciatic 
nerves which come from the fifth lumbar pair of spinal 
nerves. 

Adjustment: The lower lumbar, especially the fifth. 

Diseases of the Aorta. — The nerve supply having 
the most influence upon the thoracic and abdominal 
aorta is the second pair of thoracic nerves which originate 
from the second segment of the thoracic portion of the 
spinal cord, which is situated under the spinal process of 
the seventh cervical vertebra. 

Adjustment: For the relief of interference with the 
principal nerve supply adjust the second thoracic ver- 
tebra. 

Stimulation: For stimulation of the origin of the 
principal nerves of the aorta, use concussion over the 
seventh spinal process for vasomotor and myoconstrictor 
effects. The length of time of percussion and stimulation 
with the writer varies from live to ten minutes. 

Diseases of the Appendix. — Diseases of the appen- 
dix are permitted or caused by, in most, if not all cases, 
by an interference with the integrity with the second pair 
of lumbar nerves. 

Adjustment: Adjustment of the second lumbar 
vertebra. Relief of the second pair of lumbar nerves 
upon the right side will give instant relief in any case of 
appendicitis, and will accomplish a speedy and perma- 
nent cure in a great majority of cases. 

Stimulation: It is necessary to stimulate the nerve 



Nerve Supply and Treatment. 673 

centers to obtain relief from diseases of the appendix, 
but in case we desire so to do, we may apply concussion 
to the spinous or transverse process of the tenth thoracic 
vertebra. 

Diseases of the Bladder. — The most direct and 
potent nerve supply affecting the bladder is from the 
first lumbar pair of nerves. 

Adjustment: We should give a thrust to the spinous 
process of the first lumbar vertebra for relief of the first 
pair of lumbar nerves. 

Should bladder trouble be caused by abnormal 
ingredients in the kidney secretions, then we thrust the 
tenth thoracic vertebra for the relief of the nerve supply 
to the kidneys. 

Stimulation: This may be accomplished by percus- 
sion over the ninth thoracic or by spinal concussion to 
the spinous process of the fifth lumbar vertebra. 

Diseases of the Brain. — The brain is affected 
directly and indirectly by nerve supply from the spinal 
column. The upper cervical nerves affect the circulation 
and the integrity of the nerve supply to the brain and 
the investing membranes thereof. The middle cervical 
nerves, through the phrenic nerves, affect the expansion 
of the lungs and diaphragm, and indirectly affect the 
amount of blood in the cranial cavity. 

Adjustment: We find it necessary to adjust the 
nerves in the upper cervical region from the first to the 
fourth pair, also we relieve interference with the function 
of the brain by removing interference with the upper 
thoracic down to the sixth thoracic pair, and also lumbar 
adjustment in some cases may be found necessary. 

Diseases of the Colon. — The colon receives nerve 
supply from several segments of the spinal cord. 

Adjustment: The principal adjustment for the relief 
of diseases of the colon is the second lumbar in connection 
with the tenth and twelfth thoracic. 



674 Spondylotherapy Methods. 

Stimulation: Vasoconstrictor effects may be produced 
by concussion over the second pair of lumbar nerves, 
or by percussion over the seventh spinous process. 

Vasodilation may be caused by concussion over the 
eleventh thoracic spinous process. 

Diseases of the Ear. — The nerve supply to the ears 
is principally from the upper cervical and upper thoracic 
pairs of nerves. 

Adjustment: Relax the musculature of the upper 
cervical region by adjustment of the upper three ver- 
tebrae, also adjust the upper thoracic vertebrae from the 
second to central place, according to indications dis- 
covered by palpations. 

Diseases of the Esophagus. — The nerve supply to 
the esophagus comes from the upper thoracic and lower 
cervical nerves. 

Adjustment: From the fifth to the seventh cervical 
and from the first to the fifth thoracic as indicated. 

Stimulation: Especial vasoconstriction and tonicity 
of the esophagus may be produced by concussion over 
the spinous or transverse processes of the seventh cervical 
vertebra. 

Diseases of the Extremities. — We have the long- 
nerve trunks reaching from the spinal cord to the upper 
and lower extremities. 

Adjustment: For diseases of the arm adjust for the 
relief of the nerve supply forming the brachial plexus, 
that is, from the fifth cervical down to and including the 
second or third thoracic vertebrae. 

For diseases of the lower extremities adjust for the 
relief of interference with the lower lumbar nerves by 
adjusting from the second to the fifth vertebrae. 

Diseases of the Eyeballs. — Adjust the fifth 
thoracic vertebra for the relief of interference with the 
fifth thoracic nerve. 

Stimulation: The fifth thoracic nerve may be stimu- 



Nerve Supply and Treatment. 675 

lated by concussion over the second thoracic vertebra. 
Percussion over the first to the fifth cervical vertebrae. 

Diseases of the Eyelids. — Different diseases of the 
eyelids, as granulation, may be influenced by the adjust- 
ment of the tenth thoracic vertebra, which effect seems 
to be due to the action of this pair of nerves upon the skin 
function upon the entire body. Adjust also the middle 
cervical. 

Diseases of the Eyesight. — The pupil of the eye is 
practically under control of the middle cervical region. 

Adjustment: The fourth cervical vertebra. 

Stimulation: Concussion over the spinous or trans- 
verse processes of the third cervical vertebra. 

Diseases of the Face. — The nerve supply to the 
face is principally from the upper and middle cervical 
regions. 

Adjustment: From the second to the fourth cervical 
vertebra, and also adjustment of the upper thoracic from 
the second to the sixth vertebrae inclusive. We should 
always adjust the tenth thoracic vertebra because of the 
influence of the tenth pair of thoracic nerves upon skin 
action. 

Fevers. — By adjustment we reduce fever. First we 
stop the production of toxic elements which produce 
fever, which may be done by adjustment to restore normal 
nerve supply and normal vital resistance, which will 
check pathological processes. By adjustment we also 
stimulate the elimination of the toxic elements and thus 
remove the cause of disease. 

Adjustment: Always locate the segment or segments 
of the cord in which we detect an undue elevation of 
temperature. Adjust these segments and also adjust the 
tenth thoracic vertebra because of its influence upon the 
elimination both through the skin action and kidney 
secretions. 

Diseases of the Gums. — The gums are influenced 



076 Spondylotherapy Methods. 

principally from the nerve supply from the two segments 
of the spinal cord. 

Adjustment: The principal adjustment is the fourth 
cervical vertebra. We should always adjust the tenth 
thoracic vertebra. 

Stimulation: Concussion over the seventh cervical 
spinous process. 

Diseases of the Heart. — Different segments of the 
spinal cord through the nerves which they give off influ- 
ence but in a different manner the condition and func- 
tional activity of the heart. 

Adjustment: The principal adjustment for the heart 
is from the second to the sixth thoracic vertebrae, and the 
middle cervical vertebra. These different centers or 
segments of the cords through the nerves, which they 
give off, affect the heart as follows: 

Adjustment of the fourth cervical vertebrae increases 
the myomotor and accelerator action of the heart. 

Adjustment of the second thoracic vertebra, which 
relieves interference with the second pair of thoracic 
nerves, will re-establish the myomotor and vasocon- 
strictor tonicity of the muscles and blood vessels of the 
heart. 

Adjustment of the fourth thoracic vertebra for the 
purpose of removing interference with the fourth pair of 
thoracic nerves will establish the normal myomotor and 
vasoinhibitory control of the functional activity of the 
heart. 

Stimulation: Concussion over the third cervical ver- 
tebra will excite myomotor power, accelerate the action 
of the heart by stimulation of the origin of the fourth 
pair of cervical nerves, which originate in the neural 
arch of the third cervical vertebra. 

Concussion over the spinous process or transverse 
processes of the seventh cervical vertebra will increase 



Nerve Supply and Treatment. 677 

the myomotor power and cause vasoconstriction of the 
musculature and vascular apparatus of the cardiac organ. 

Concussion over the spinous or transverse processes 
of the first and second thoracic nerves would increase 
the myomotor power and establish the inhibitory control 
of the heart's action. 

It is further claimed that concussion over the pro- 
cesses of the lower thoracic vertebrae from the eighth to 
the twelfth will produce vasodilation of the heart walls 
and vessels. 

Diseases of the Kidneys. — The kidneys receive 
their nerve supply from the lower thoracic nerves and 
from the plexuses of the sympathetic system. 

Adjustment: The principal adjustment for the kid- 
neys is the tenth thoracic vertebra for the relief of the 
tenth thoracic nerves which have the most potent influ- 
ence upon the functional action of the kidneys. Palpitate 
and adjust where indicated from the ninth to the twelfth 
thoracic vertebras. 

Stimulation: Concussion over the middle thoracic 
vertebrae will cause vasoconstriction. 

Concussion over the lower thoracic or upper pair of 
lumbar will cause vasodilation and atonic action of the 
renal organs. 

Diseases of the Larynx. — The larynx is affected 
mostly from the middle thoracic region. 

Adjustment: The fifth thoracic vertebra and also 
the middle cervical vertebra. 

Stimulation: Concussion over the spinous or trans- 
verse processes of the seventh cervical vertebra. 

Diseases of the Liver. — The liver receives its prin- 
cipal nerve supply from the middle thoracic nerves and 
those immediately below. 

Adjustment: Seventh thoracic vertebra, and to affect 
more of the nerve supply to the liver we adjust from the 
eighth or tenth up to the sixth thoracic vertebrae inclusive. 



678 Spondylotherapy Methods. 

Stimulation: For constriction of the liver concussion 
should be applied to the processes of the first and second 
thoracic vertebrae for myomotor influence, and over the 
first and second lumbar for constriction of the liver. 

For vasodilation of the liver, concussion should be 
applied over the spinous or transverse process of the 
tenth and eleventh vertebrae. 

Vasoconstriction may be produced by concussion over 
the upper thoracic from the seventh cervical to the sixth 
thoracic vertebra. 

Diseases of the Lungs. — The lungs are supplied and 
influenced by nerves from different regions of the spinal 
cord and the brain. 

Adjustment: Upper cervical for the relief of the first 
and second cervical pair of nerves which join and influence 
the pneumogastric. 

Adjust the middle cervical for the relief of the third, 
fourth and fifth cervical pair of nerves which form the 
phrenic nerves, which supply the pericardium, pleura and 
diaphragm. 

Adjust the upper thoracic for the relief of the second 
pair of thoracic nerves, which supply and influence the 
bronchial tubes. 

Adjust the third thoracic vertebra for the third tho- 
racic nerves, which supply most directly the lungs and 
pleura. 

Adjust from the fourth to the sixth thoracic vertebrae 
to relieve the lungs and the diaphragm. 

Stimulation: Concussion applied to the fourth and 
fifth cervical vertebra, for the stimulation of the nerves 
originating in that region, will cause vasoconstriction and 
stop hemorrhages of the lungs. 

Concussion over the middle thoracic vertebrae applied 
to the spinous or transverse processes of the fifth to the 
eighth will cause vasodilation of the pulmonary organs. 

Diseases of the Ovaries. — The nerves which supply 



Nerve Supply and Treatment. 679 

the ovaries come from the lumbar nerves and the principal 
adjustment is the third lumbar vertebra. 

Adjustment of any of the lumbar vertebrae according 
to indications of the existence of spinal lesions may be 
necessary. 

Diseases of the Pancreas. — Adjustment: The prin- 
cipal adjustment for the deranging of the function of the 
pancreatic gland is the eighth thoracic vertebra. 

Adjustment of other vertebrae of adjacent segments 
to the eighth may also be necessary. 

Stimulation: Concussion applied to the processes of 
the fourth and fifth thoracic vertebrae will cause vaso- 
constriction. 

Diseases of the Peritoneum. — The principal adjust- 
ment for diseases of the peritoneum is the second lumbar 
vertebra. 

The peritoneum may be affected by adjustment 
establishing the integrity of the nerve supply from the 
sixth thoracic spinal segment down to and including the 
second lumbar, according to indications of lesions which 
may be determined by careful palpation. 

Diseases of the Pharynx. — The nerve supply to 
the pharynx is similar to that of the larynx, and the 
adjustment is the same as for the larynx. See adjustment 
for larynx above. 

Diseases of the Pleura. — The nerve supply to the 
pleura is similar to that of the lungs. 

Adjustment: The pleura is most affected and con- 
trolled by the third pair of thoracic nerves. Also adjust 
the middle cervical. 

Stimulation: Concussion applied to the fourth cer- 
vical will cause constriction. Concussion applied to the 
middle thoracic vertebra from the third to the eighth will 
produce dilation of the lungs and pleura. 

Diseases of the Prostate. — The prostate glands 



680 Spondylotherapy Methods. 

may be influenced from the lower thoracic nerves, through 
the lumbar nerves or through the sciatic nerves. 

Adjustment: First lumbar, fourth and fifth lumbar 
vertebrae. 

Stimulation: Concussion applied to the processes of 
the ninth and twelfth dorsal vertebrae. 

Concussion over the twelfth is claimed to be the most 
potent in the treatment of prostatic hypertrophy. 

Diseases of the Rectum. — Adjustment: Fifth lum- 
bar vertebra and often dilation of the rectal sphincters is 
necessary. By dilation we can avoid operation. 

Diseases of the Scalp. — The direct nerve supply to 
the scalp is from the upper cervical region. 

Adjustment : The upper three cervical vertebrae should 
be adjusted for the relief of the nerve supply to the 
scalp. 

Adjust the tenth thoracic vertebra, because of the 
influence of this pair of nerves upon the skin action of 
the entire body. 

Diseases of the Sexual Organs. — The principal 
nerve supply to all the pelvic organs is from the lumbar 
nerves and from the lower thoracic nerves which contrib- 
ute their supply by sending white rami communicantes 
which form the downward stream to the ganglionic cords 
sympathetic. 

Adjustment: The principal nerve supply to the sexual 
organs is relieved by adjustment of the second, third 
and fourth lumbar vertebrae. 

These organs are also influenced by adjustments 
which affect the lower thoracic nerves, which contribute 
the white rami communicantes, forming the descending 
stream, which passes downward in the gangliated cords 
of sympathetic system which supply the pelvic organs. 

Diseases of the Small Intestines. — Adjust accord- 
ing to indications from the seventh to the twelfth thoracic 
vertebrae. 



Nerve Supply and Treatment. 681 

Stimulation: We may cause contraction of the small 
intestines by an adjustment of the second lumbar ver- 
tebra or by concussion applied to this segment. 

We may produce dilation of the intestines by con- 
cussion over the eleventh thoracic vertebra with the 
pleximeter applied to either the spinous or transverse 
processes. 

Diseases of the Spleen. — Adjustment: The prin- 
cipal adjustment for diseases of the spleen is the sixth 
thoracic vertebra for the relief of interference with the 
sixth thoracic pair of nerves. 

Diseases of the Stomach. — The stomach lies just 
below the diaphragm and receives its nerve supply 
principally from near the center of the thoracic portion 
of the spinal column. 

Adjustment: The fifth thoracic segment is called 
stomach place and our principal adjustment is for relief 
of the fifth thoracic pair of nerves. 

We influence the stomach indirectly by adjustment 
of the upper cervical vertebrae, per the pneumogastric. 
The stomach is influenced reflexly because of the dis- 
turbance of the pelvic organs, which disturbance may be 
relieved by lumbar adjustment. 

Stimulation: We may cause dilation of the stomach 
by concussion applied to the spinous or transverse pro- 
cesses of the eleventh or twelfth thoracic vertebra?. 

Contraction of the stomach may be caused by con- 
cussion over the spinous processes of the upper two or 
three lumbar vertebrae and the second thoracic vertebra. 

Diseases of the Suprarenal Capsules. — Adjust- 
ment: Ninth and tenth thoracic and fourth cervical 
vertebrae. 

Stimulation: Percussion over the processes of the 
fifth, sixth, and seventh thoracic vertebrae will cause 
vasoconstriction. 



682 Spondylotherapy Methods. 

Percussion over the eleventh and twelfth thoracic 
processes will cause vasodilation. 

Diseases of the Teeth. — Adjustment: Fourth cer- 
vical and fifth thoracic vertebrae. 

Stimulation: Concussion over the process over the 
seventh thoracic vertebra and the third cervical. 

Diseases of the Throat. — The throat is influenced 
by direct nerve supply and also by an indirect nerve 
supply. 

Adjustment: The fifth thoracic vertebra is the 
principal adjustment. 

The throat is also influenced by the nerve supply 
from, and consequently the adjustment of, the middle 
and lower cervical regions. 

Concussion may be applied over the seventh thoracic 
vertebra. 

Diseases of the Thyroid Glands. — Enlargement of 
the thyroid glands and exophthalmic goiter may be 
helped and cured by spondylotherapy as follows: 

Adjustment: Adjust the third and fifth thoracic 
vertebrae and also adjust the fifth and sixth cervical 
vertebrae. 

Stimulation: Percussion should be applied over the 
spinous or transverse processes of the seventh cervical 
vertebra. 

Diseases of the Tongue. — Diseases of this organ 
may be readily relieved by removing all interference with 
integrity of the nerve supply of this organ. 

Adjustment: The fifth thoracic vertebra and also the 
middle and lower cervical vertebrae. 

Stimulation: Concussion should be applied to the 
spinous or transverse processes of the seventh cervical 
vertebra. 

Diseases of the Tonsils. — Adjustment: The treat- 
ment of the diseases of the tonsils is practically the same 
as that for the diseases of the tongue. 



Nevre Supply and Treatment. 683 

Diseases of the Uterus. — Adjustment: The prin- 
cipal adjustment of uterine diseases is that of the fourth 
lumbar vertebrae. 

Stimulation: Constriction of the uterus may be 
produced by concussion applied to the thoracic or to 
the spinous processes of the upper two lumbar vertebrae. 



CHAPTER II. 
POINTS OF CONTACT. 

IN this connection we call your attention briefly to 
the different points of contact of the hand used 
upon the processes of the vertebrae. We enumerate 
below the different forms of contact generally used in our 
work: 

I. Thumb contact. 
II. Ulnar contact. 

III. Pisiform contact. 

IV. Hollow of hand contact. 
V. The finger ends contact. 

VI. The ball of thumbs contact. 
VII. The folded fingers contact. 

I. Thumb Contact. (See Illustration, page 522). — 
This contact is used in the adjustment of the cervical 
vertebrae, and also in the adjustment of thoracic and 
lumbar vertebrae. The thumb is used in making contact 
with the spinous processes for the purpose of adjustment 
in the cervical and lumbar regions and also in the upper 
thoracic region. 

In using the T. M. method and the rotary method 
in the cervical region we use the thumb contact. In the 
occipito-spinous method of adjusting the upper thoracic 
vertebrae, the thumb contact is used almost exclusively. 
We cross the thumbs and use them upon the transverse 
process of the thoracic vertebrae, but do not make any 
contact or give any thrust upon the transverse process 
of the lumbar vertebrae, because they are generally too 
light and slender. 

The thumb contact is an easy method of adjustment 
of the thoracic vertebrae, but we should always be sure 

684 



Points of Contact. 



G85 




Illustration of points of contact. 



686 Spondylotherapy Methods. 

we make an adjustment of the vertebra and not be fooled 
by the click of the articulations of the ribs. 

II. Ulnar Contact. (See Illustration, page 513.)— 
The ulnar contact may be used in giving adjustment in 
any portion of the spinal column. The ulnar contact is 
best adapted for use in the lower two-thirds of the thoracic 
region and in the lumbar region. In the use of the ulnar 
contact it is best to place the hand flat upon the patient's 
back, with the ulnar border superior, and upon the 
vertebra to be adjusted. 

The flat hand will not excite the reflex contraction of 
the musculature of the spine, as is apt to be done if the 
hand is held on edge. The ulnar border of contact is 
used perhaps more extensively than any other method 
and has some advantages over the other methods of 
adjustment, provided the hand is held as it should be. 
Any portion of the ulnar border may be used from the 
little finger back to the pisiform process. 

III. Pisiform Contact. (See Illustration, page 
509.) — This contact is by no means a comfortable contact 
for the patient owing to the fact that the point of con- 
tact is too concentrated and sharp. This contact is 
most useful in lumbar adjustment in which there is a 
lateral inclination of a spinous process. This contact 
may also be used in giving the lateral thrust to the 
spinous processes of the upper thoracic vertebrae. 

We do not use nor recommend the use of the pisifoim 
contact in the adjustment of the thoracic vertebras of 
the lower two-thirds except in case of lateral non-align- 
ment of the spinous processes of vertebrae that are really 
rotated upon their axes because of unilateral contraction 
of the spinal musculature. 

IV. Hollow of Hand Contact. (See Illustration, 
page 518.) — The hollow of the hand contact is one of the 
most comfortable contacts that we use and this contact 
has many advantages. 



Points of Contact. 687 

When using the hollow of the hand contact the hand 
should lie with the fingers extending superior and parallel 
with the line of the tips of the spinous processes. The 
spinous process to which the thrust is to be applied rests 
at the point indicated on the hand which is in the center 
of the hand and just below the metacarpal wrist artic- 
ulations. 

The ball of the thumb and the pad of muscular tissue 
on the anterior surface of the ulnar border of the hand 
will come in contact with the transverse processes on 
either side. In the use of the hollow of the hand contact 
we use also the ball of the thumb and the pisifoim or 
ulnar contact; the latter two contacts being upon the 
transverse processes, while the spinous process is in con- 
tact with the hollow of the hand. 

When the hand lies flat on the back as the patient 
lies upon the treatment table, with the fingers extending 
horizontal and superior, the feeling is very comfortable 
to the patient, and will not excite any reflex contraction 
that will tend to prevent the adjustment being easily 
made. 

This contact may be used throughout the lower two- 
thirds of the thoracic region and in the adjustment of all 
the lumbar vertebrae except the fifth. In case the fifth 
lumbar vertebra is anterior this contact cannot be used 
except to the superior portion of the sacrum. In case 
of a posterior condition of the fifth lumbar, which is 
seldom if ever found, the hollow of the hand contact 
may be applied to give the thrust, the direction of which 
should be downward and forward. 

This contact is one of the best that we use in giving 
the spinal thrust and it is a contact that gives absolute 
control as to direction of the thrust to be applied. 

V. The Finger-ends' Contact. — In adjusting the 
cervical vertebrae by applying a thrust to the transverse 
processes, in loosening up all the cervical vertebrae 



688 Spondylotherapy Methods. 

simultaneously, we use the ends of the fingers in contact 
with the posterior portion of the transverse processes. 

We also use the ends of the fingers in palpating for 
tender nerves and in giving nerve pressure and in nerve 
tracing. 

VI. The Ball of Thumb Contact. — This contact is 
used in making adjustment of the vertebrae of the lower 
two-thirds or three-fourths of the thoracic region, and 
may be used advantageously in the adjustment of the 
upper two or three lumbar. The ball of the thumb con- 
tact is made to the spinous process of the vertebrae to 
be adjusted. The hand, making the contact of the ball 
of the thumb, is reinforced by the other hand, with the 
ball of the thumb contact to the dorsal portion of the 
contact hand. 

In using the ball of the thumb contact the fingers 
extend superior and outward from the line of the spine 
at an angle of some forty-five degrees. The entire palmar 
surface of the contact hand and the greater portion of 
the palmar surface of the reinforcing hand, are in con- 
tact with the surface of the patient's back. The specific 
point of contact is directly upon the spinous process, to 
which the thrust is to be given. 

The broad expanse of the contact on the patient's 
back makes the sensation to the patient palliative, and 
tends to the relaxation of the spinal musculature, and 
in this way, the adjustment is made more easy of attain- 
ment, and practically free from discomfort and pain. 
This contact we consider our best contact throughout 
the region where it is adaptable, because of both the 
comfort of the patient and of the ease and control of the 
direction of the thrust. 

VII. The Folded Finger Contact. — In the cervical 
we sometimes make adjustments by a contact of the 
folded fingers against the spinous and transverse pro- 
cesses. 



Points of Contact. 689 

The contacting portion of the fingers is the dorsal 
portion, between the terminal and middle phalangeal 
articulations. This contact furnishes a larger or more 
extensive contact than the ulnar border contact in giving 
cervical adjustments. 

The uppermost portion of the contact should rest 
upon the spinous or transverse process of the vertebra 
to be moved, which movement is for the purpose of 
relieving the articulation, by opening it up, which is 
between the vertebra that is adjusted and the one imme- 
diately above. 

This contact has some advantage in the cervical 
region for the reason that it is more extensive than the 
ulnar border and more narrow and adaptable than the 
entire palmar surface of the hand contact. 



CHAPTER III. 
SPONDYLOTHERAPY METHODS. 

WE will, in connection, call your special attention 
to a few rules which should govern us in the 
administration of thrusts for the relaxation of 
ligaments affecting the integrity of the spinal articula- 
tions, and for the purpose of freeing tender nerves, after 
they have been located by palpation, in the different 
portions of the spine. 

The proper point for the administration of the thrust, 
for the purpose of relieving a tender nerve, may be 
determined by the relation of the exit of the spinal nerve 
to the spinous process to which the thrust is given. We 
may palpate a tender nerve in the cervical region; we 
may palpate a tender nerve in the thoracic region; or, 
we may palpate a tender nerve in the lumbar region, 
and in each region we should thrust a vertebral process 
in certain relation to the tender nerve which may be 
either even with the nerve or below it, and this depends 
upon the region in which we are palpating and adjusting. 

Now the specific manner of relieving the nerve in the 
different regions varies, owing to the fact that the rela- 
tion of the exit of the spinal nerve to the process of the 
vertebra to be adjusted varies in the different regions 
owing to the length and the direction of the spinous 
process, and the shape of the body of the vertebra. 

We may palpate a tender nerve on the left side of 
the spinal column; we may palpate a tender nerve on 
the right side of the spinal column; now, the direction 
of the application of the thrust will vary, according to 
the side upon which we palpated the tender nerve. 

Relieving Nerves in the Cervical Region. — 
First, we will suppose that we palpate a tender nerve 

690 



Spondylotherapy Methods. 691 

upon the right side in the cervical region. We may also 
palpate a slight rotation of the spinous process of the 
vertebra whose centrum is above or below the tender 
nerve. 

If the spinous process of the third, fourth, or fifth 
vertebra of the cervical region is rotated to the left, then 
we will find tenderness of the nerve upon the same side. 

The proper method of procedure is to rotate the 
vertebra whose spinous process is lateral, back into the 
proper alignment, which we do by a forward rotary 
thrust on the transverse process of the vertebra. The 
thrust is applied to the opposite side to which the tender 
nerve is palpated. Should we adjust by the old method, 
namely, turning the head to one side and then by giving 
a downward thrust on the cervical region, then we should 
observe the following rule : 

Turn the face so that the side of the neck upon which 
we find the tender nerve, is turned toward the table, or 
downward; then give a thrust to the spinous process 
that is directly opposite the tender nerve, thrusting it 
downward. This will separate the vertebral articulation 
that is impinging and causing the tender nerve by opening 
the foramina through which the spinal nerve makes its 
exit. 

The same rule will apply to all of the cervical vertebrae. 
We should always observe the one rule: Always apply 
the thrust to the opposite side of the tender nerve, and to 
the spinous process that is on a level, or even with the tender 
nerve. 

We may also relieve a tender nerve in the cervical 
region by giving a thrust to the same side of the neck on 
which we find the tender nerve. In case we do so, we 
should apply the thrust to the spinous process immediately 
below the tender nerve. In this way we rotate the ver- 
tebra below the tender nerve on its axis, and open the 



692 Spondylotherapy Methods. 

foramen that is narrowed, causing the nerve impinge- 
ment. 

Relieving Nerves in the Thoracic Region. — In 
the thoracic region we relieve nerves according to certain 
rules as to the process to which the thrust is given, but 
the rules for applying the thrust in the different regions 
of the thoracic portion of the spine vary. The following 
general rule will apply: 

When we locate a tender nerve by palpation, we may 
always relieve that nerve of its tenderness, and relieve the 
pain, should it exist, by applying a thrust to the first spinous 
process below the plane or level of the tender nerve. 

In the upper thoracic region, we will find the follow- 
ing exception to our rule, namely, the level of the nerve 
will correspond to the interspaces between two spinous 
processes; but in such cases we adhere to the rule to 
adjust the spinous process immediately below the level 
of the tender nerve. 

The same rule holds true in the lower thoracic region, 
from the tenth to the twelfth pair of nerves inclusive. 
The tender nerve is even with the interspace between 
the spinous processes of the vertebrae immediately above 
it. 

In the central portion of the thoracic region we 
usually find a tender nerve about even with, or slightly 
above a spinous process. In this case, we do not apply 
the thrust to the spinous process which is even with the 
tender nerve, for the reason that this will open up an 
articulation above the tender nerve. This fact is owing 
to the length and obliquity of the spinous processes in 
the middle thoracic region. In this case, we should 
proceed as follows: 

Find the spinous process that is even with, or slightly 
below the tender nerve. Then apply the thrust to the spinous 
process below the one that is even with the nerve. The 



Spondylotherapy Methods. 693 

thrust applied according to the above directions in the 
thoracic region, should be as follows: 

Always apply the thrust so as to throw the spinous 
process adjusted toward the side of the tender nerve. You 
should vary the direction of the thrust from a straight 
downward and forward direction. If you should thrust 
this process in the opposite direction, you would increase 
the impingement and would fail to give relief from the 
nerve impingement. The following rule is simple and 
easy to remember: 

Throw the spinous process below the level of the tender 
nerve, slightly toward the side of the tender nerve, and forward. 

We may relieve a tender nerve in any portion of the 
thoracic region by adjusting the process below the one 
designated above. This, however, is not as specific and 
successful a way as the rule we have given. 

Should you prefer, though, to relieve the nerve by 
adjusting the second process below the level of the nerve 
in the middle thoracic, then the thrust should be applied 
as follows: 

Stand on the side of the tender nerve, and thrust the 
spinous process backward, downward, and from the side 
of the tender nerve. 

We may relieve tender nerves in the thoracic region 
by applying the thrust to the transverse process and to 
do so we should observe the following rule: 

First, give the thrust on the same side of the tender 
nerve. 

Second, apply the thrust to the transverse process 
immediately over and above the tender nerve. 

Third, thrust the transverse process downward and 
forward on same side and over tender nerve. 

Relieving Nerves in Lumbar Region. — The relief 
of nerve impingment or nerve interference in the lumbar 
region, is more simple, because it is easier to comprehend 
the arrangement, but it is more difficult to open up the 



694 Spondylotherapy Methods. 

lumbar articulations owing to the amount and strength 
of the musculature connecting and approximating the 
vertebrae. The rule to follow is simple: 

If the nerve is tender upon the right side of the second 
lumbar spinous process, as it will be in appendicitis, and 
inguinal hernia, then the thrust should be given to the 
second lumbar spinous process, as a tender nerve even 
with it makes its exit from the neural canal between the 
centrums of the second and third lumbar vertebrae. 

This thrust should be forward to open up the articu- 
lations, and it should be toward the right side or toward 
the tender nerve, to relax the tissues upon the right side 
of the spinal column. 

Should the nerve be tender upon the left side, then 
the thrust should be toward the left side, and forward, 
that we may relax the tissues upon the left side of the 
lumbar vertebrae. 

The rule in brief, to follow in all lumbar adjustments, 
is, viz., apply the thrust to the spinous process that is even 
with the tender nerve, and to throw the process forward and 
slightly toward the side of the tender nerve. This rule 
applies to the adjustment of all of the lumbar vertebrae. 
We should never attempt to adjust a lumbar vertebra 
by giving a thrust upon the transverse processes. 

However, other methods than the direct thrust may 
be used in some cases. We may loosen up two or more 
articulations at one time. Should we attempt to relieve 
nerves in this way, we should follow the directions given in 
the preceding chapter on Methods of Spinal Adjustment. 

SPECIAL RULES FOR GIVING THE THRUST. 

'HPHE manner in which a thrust is given may determine 
the success of the thrust. 
First, in giving the direct thrust to a spinous process, 
we should use a contact that is not irritating or exciting 



Spondylotherapy Methods. 695 

to the patient, so that we may avoid the excitation caus- 
ing involuntary reflex muscular contraction. 

If an adjustment is secured in spite of the contracted 
condition of the muscles it will be painful to the patient. 
Complete relaxation is the prerequisite that is desirable 
and necessary in giving adjustment with the least possible 
pain or discomfort to the patient. To secure relaxation 
sometimes, is difficult. We may . secure relaxation in 
different ways, as follows: 

1. Deep breathing. 

2. By flexing the spine. 

3. A change of position. 

4. By diverting the mind. 

5. Manipulating spinal tissues. 

1. Deep Breathing. — The act of deep breathing 
calls for alternate contraction and relaxation of the 
muscles of respiration, and incidentally the attachment 
of the muscles, which have to do with respiration, affect 
the integrity of the tonicity of the spinal column. 

If the patient is encouraged to take a deep breath and 
expand the chest while doing so, the muscles are con- 
tracted, and then if the patient exhales completely, there 
will be a complete relaxation of the muscles of respiration, 
and consequently we notice a relaxation of the spinal 
musculature. If the thrust is given at the end of expira- 
tion, it will be given when the spine is thoroughly relaxed. 

In this way, we may be enabled to open up articula- 
tions that we cannot open up in any other way, for the 
reason that any spinal contraction tends to prevent 
adjustment. 

2. By Flexing the Spine. — When the hand is in 
position, and we have the proper contact with the 
spinous process to which a thrust is to be given, we may 
bear down and flex the spine, and by relaxing and again 
flexing a time or two, the patient will begin to co-operate 
with us, and when he does, and relaxes the spine so that 



696 Spondylotherapy Methods. 

it may be flexed, you may follow the pressure that flexes 
the spine, with the increased impulse of the thrust that 
makes the adjustment. 

3. A Change of Position. — Changing position of 
the head or face from one side to the other, is a helpful 
method of obtaining relaxation. 

If the point of contact of your hand is against the 
process to which the thrust is given, you may ask the 
patient to change the face to the other side of the table. 
When the head is raised to change the face, that move- 
ment of necessity will relax the spinal musculature. 

While the relaxation is on, and while the patient's 
mind is diverted from the thrust, to the action of changing 
the face from one side to the other, the thrust may be 
given, and given successfully. 

We have in our experience, had the head changed 
from one side to the other, while we gave one adjustment, 
and had the head turned to the other side while we gave 
another adjustment. Then we have had the patient 
remark, "I know what you did that for." 

4. By Diverting the Mind. — Diverting the mind is 
another important measure to overcome any resistance 
on the part of the patient. 

If, while you are placing the hand, you do so lightly, 
you may divert the patient's mind by talking to him 
about his symptoms, age, or any other subject in which 
you may be able to get him deeply interested. Diversion 
of the mind from the thrust helps in two ways: 

1. If the mind is occupied by some interesting subject 
there will not be so much susceptibility to pain as if the 
mind is directed to, and expecting pain. 

2. A diversion of the mind will cause the patient to 
relax better than if the mind is directed toward the 
point of contact. 

5. By Manipulating Spinal Tissues. — Massage, 
kneading, vibration, or any palliative method of treat- 



Spondylotherapy Methods. 697 

ment of the spinal column, preparatory to adjustment, 
tends to allay the nervous excitation and contraction of the 
musculature of the spinal column; hence such treatments 
are to be recommended before the thrust is given, to 
open up the spinal articulations. 

Sometimes it is necessary to use hot applications or 
alternate hot and cold applications, together with massage 
and vibration, for several days before we try to give the 
thrust, especially to spines that are settled and con- 
tractured as a result of advanced life or chronic disease. 

RULES FOR PREVENTING SORENESS. 

/^\NE difficulty that is met with in the practice of 
^^ spinal adjustment, is soreness which will be caused 
by relaxing contracted ligaments of the spine. 

When ligaments are shortened so as to approximate 
vertebra?, they must of necessity be stretched to relieve 
the approximation. Stretching these ligaments or tendons 
of the musculature of the spine will injure some of the 
fine fibrilla. This will tend to produce a soreness. Sore- 
ness produces two bad effects, as follows: 

1. Contraction of the spine. 

2. Prevention of treatment. 

According to the law of contraction of any tissues, 
injury to the fibers thereof will excite a contraction. We 
may give a thrust to-day and loosen an articulation. In 
some cases the soreness produced thereby will cause a 
contraction by to-morrow. The good we have done is 
only temporary. After the subsequent contraction, 
following the adjustment, our patient will be no better 
than before treatment. This should be understood by 
the practitioner, and explained to the patient, especially 
when there are contractions of any consequence to be 
relieved. We may lessen the amount of soreness by 
certain precautions. 



698 Spondylotherapy Methods. 

Kneading, massage, vibration, hot application, etc., 
to prepare the spine for adjustment, will prevent the 
soreness that would result without such preparation. 
Vibration following the adjustment, tends to prevent 
the development of soreness in the spinal musculature, 
and a Faradic current of electricity is claimed to be the 
best preventive against soreness from adjustment that 
has yet been discovered. 

One mistake that is often made by practitioners of 
spinal adjustment, is that they give their adjustments 
too frequently. Most people practicing spinal adjustment 
will treat their patient's spines daily. Some will admin- 
ister spinal adjustment twice daily, and the limit has 
been reached by some who teach that adjustment should 
be given every ten minutes in certain cases of acute 
diseases. 

Common intelligence would teach a person better 
than this, and our experience has taught us that in 
typhoid fever that one adjustment per day is better 
than two, and we have further learned by experience 
that adjustment on alternate days is better than adjust- 
ment on every day, in the great majority of cases of 
chronic disease. 

An adjustment given every other day does not cause 
that soreness and reaction that is excited by the daily 
adjustment. Patients will build up in strength and 
should improve from day to day if the adjustments are 
given on alternate days. Whereas, if they are given 
every day, we find that the patient often runs down 
under the treatment and will fail to improve in health 
until after they have discontinued treatment. After 
discontinuing their treatment, the gradual gain in many 
cases is greater than while being adjusted. 

No doubt the adjustments are responsible for the 
improvement, but they do not receive the credit. The 
impression of the common mind is, that "I did not do 



Spondylotherapy Methods. 699 

well while I was taking treatment, but I am getting along 
very well since I quit." They cannot see the connection 
between the loosening up of the spinal column and their 
subsequent improvement of health. Some of our most 
successful representatives in spinal treatment adjust 
all their patients only on alternate days. 



CHAPTER IV. 

EXAMINATION OF URINE. 
By W. H. Vawter, Ph. G. ; D. C. 

URINE is the most important excretion of the 
animal organism, and a careful analysis may 
furnish much valuable information relative to 
body metabolism, qualitatively by the appearance of 
abnormal substances in the excretion, and quantitatively 
by the variation of its normal constituents, and we are 
thus greatly enlightened as to facts bearing on diagnosis 
and prognosis. 

We will here attempt to outline in a very brief manner 
the most important points to be considered from a 
physical and chemical standpoint, and describe some 
tests for the most important abnormal constituents, and 
which may be utilized with the minimum amount of 
apparatus and experience. 

SELECTING A SPECIMEN OF URINE. 

TN obtaining a specimen for examination, it should 
A preferably represent the mixed urine voided in twenty- 
four hours, as the specific gravity, reaction, etc., are 
known to vary during this period. 

When this is not possible the selection must be 
determined by circumstances, it being well to remember 
that abnormal substances, existing only in traces, are 
more readily detected from a specimen taken about three 
hours after a hearty meal. For some purposes an abso- 
lutely fresh specimen is required. 

700 



Examination of Urine. 701 

CHARACTERISTICS OF NORMAL URINE. 

Tl ECENTLY voided normal urine may be described 
-^ as a transparent aqueous fluid, color light yellow 
to dark straw or brownish yellow. Reaction acid usually. 
Specific gravity 1015 to 1025. The odor can only well 
be indicated as characteristic. The solid constituents 
are principally urea together with earthy phosphates 
and other salts. 

Quantity voided in twenty-four hours from 1000 
C. C. to 1500 C. C. 

AS TO TRANSPARENCY. 

npHIS is quite constant in freshly voided normal urine. 
■* It does not necessarily follow, however, that, from 
the fact that a given specimen of urine is transparent, it 
is normal. 

Normal urine, transparent when voided, commonly 
develops, after standing a few minutes, a light cloud 
floating somewhere between the top and bottom, and 
gradually settles. This is composed of mucus and a few 
epithelial cells, and is not abnormal. 

At certain hours of the day, some two or three hours 
after a heavy meal, the freshly passed urine may be 
turbid from the presence of earthy phosphates. These 
shortly after voiding begin to subside and usually within 
an hour have formed a bulky precipitate, leaving a clear 
supernatant liquid. 

To determine the nature of such sediment a few drops 
of nitric acid may be added, when it will be immediately 
dissolved if it be earthy phosphates, or the application 
of heat will increase it. 

The earthy phosphates require an acid urine to retain 
them in solution, a lessened degree of acidity may bring 
about their precipitation and this will be more pronounced 
by an alkaline reaction. The tendency toward alkalinity 



702 Examination of Urine. 

always occurring during digestion it may readily be seen 
why this condition is usually observed at certain hours. 
The presence of the earthy phosphates as herein explained 
cannot be considered abnormal. 

Through the precipitation of the urates, due to a 
considerable reduction of temperature after being passed, 
there may be turbidity. While readily soluble in water 
at body temperature the urates are promptly thrown 
out of solution by a reduced temperature in normal urine. 

The precipitate subsides, as with the earthy phos- 
phates, leaving a clear supernatant liquid, the precipitate 
having a white or pinkish-white appearance and not so 
bulky as that of the phosphates. 

In testing this precipitate we find that the application 
of heat quickly dissolves the urates, while a sediment of 
phosphates is increased by heat. 

Normal urine permitted to stand for some time 
undergoes ammoniacal fermentation, the reaction grad- 
ually changes from acid to alkaline and a bulky precipitate 
of phosphates and ammonium urate is formed, together 
with numerous bacteria. In this case the supernatant 
liquid is permanently cloudy, due to bacteria, which is 
not overcome by filtration. 

This fact makes plain the necessity of examining 
fresh specimens of urine, especially in warm weather. 
The application of chemical as well as microscopical 
examination of sediment are far from satisfactory in a 
decomposing specimen and may lead to wrong conclusions. 

Pathologically urine may be cloudy or more or 
less opaque, from the above conditions, in abnormal 
degree. From the presence of pus, which together with 
mucus will remain in suspension for several hours, mucus 
being absent it will subside quite rapidly. 

The addition of an alkali to a sediment of pus converts 
it into a slimy, tough mass. 



Examination of Urine. 703 

Pus suggests an inflammatory involvement of the 
geni to-urinary tract. 

Consistence. — Normally urine is always aqueous, 
that is, it flows freely and may be dropped readily like 
water. 

Pathologically it frequently becomes viscid and 
separates into drops with great difficulty. This may be 
due to an excess of mucus or to pus and mucus, and 
usually occurs in an alkaline urine in which pus is present. 

Color. — Normal urine may vary in color from light 
yellow to a dark straw or brownish-yellow, this variation 
in health depending on quantity voided and hence greater 
or less dilution of the pigments to which it owes its color. 

Pathologically the color may vary greatly. It 
may be practically colorless in diabetes, nervous condi- 
tions, and chronic interstitial nephritis. In febrile condi- 
tions it is usually very highly colored. The urine is also 
colored after the administration of certain drugs. In 
case of blood in the urine, if specimen is recently passed, 
it will present a bright red color, if same comes from a 
hemorrhage in the urethra or neck of the bladder; while 
there will be a reddish-brown, sometimes smoky, pre- 
cipitate should the blood come from the kidneys. 

This occurs from the fact that in the latter case the 
blood has been in contact with the urine for some time, 
to which is due the darkened color through its effect on 
the hemoglobin. 

In the former case the blood does not come in contact 
with the urine until same is voided, hence the bright red 
color. It is obvious that an absolutely fresh sample is 
essential to draw this distinction nicely. 

The Reaction of normal mixed urine, voided in a 
period of twenty-four hours, is acid, and usually speci- 
mens passed at any time of day give this reaction, though 
different in degree; after meals it may present a neutral 
or faintly alkaline reaction. 



704 Examination of Urine. 

Pathologically increased acidity is usually observed 
in fevers, inflammation of liver, acute rheumatism, 
neurasthenia, and hyperchlorhydria. 

In cases of undue retention, chlorosis, and marked 
general debility, the urine frequently presents an alkaline 
reaction. 

Litmus paper is used for determining the reaction; 
acid urine turns blue litmus paper red and alkaline turns 
red litmus paper blue ; neutral urine has no effect on the 
color of either. 

The Specific Gravity usually ranges from 1015 to 
1025, varies as does the amount voided, and depends 
upon the quantity of solids in solution. The specific 
gravity may, however, be somewhat greater or less than 
above mentioned within the bounds of health. 

Pathologically the specific gravity of urine is 
increased or decreased. It may be high with a large 
volume as in diabetes mellitus, or low with a small volume 
indicating incomplete elimination, as in the latter stages 
of acute disease and many chronic wasting diseases. The 
specific gravity should be taken from a mixed specimen, 
voided in a period of twenty-four hours, that the inference 
therefrom may be reliable. 

To determine specific gravity readily and with a 
reasonable degree of accuracy the urinometer is used for 
routine work. An instrument of reliable manufacture 
should be selected and one with jar amply large to permit 
the urinometer to float with perfect freedom therein. 
All foam should be removed from the surface of the urine, 
care should be observed that the urinometer does not 
adhere to sides of jar, and float freely, reading should be 
carefully taken at lower meniscus. Urinometers are 
usually standardized at a temperature of 15 C, and 
specimen should have this temperature as nearly as 
practical. 

When the specimen is not sufficient in volume to 



Examination of Urine. 705 

float the urinometer, dilution may be made with an equal 
volume of pure water and the reading on the urinometer 
scale multiplied by two, or diluted with three volumes 
of pure water and reading multiplied by four. 

Odor. — We do not gain much of importance from this 
source. But little can be said of the odor of normal 
urine, other than it is characteristic, this, however, may 
be observed to vary somewhat in intensity, perhaps 
largely due to the degree of concentration. 

Urine which has been standing exposed, especially to 
warm temperature, acquires an ammoniacal odor through 
fermentation and putrid through decomposition of mucus 
and other organic matter. The peculiar odor of certain 
drugs and vegetable foods are very readily imparted to 
the urine. 

Pathologically little of clinical value is gained from 
this source. A peculiar sweetish odor is commonly 
observed in diabetic urine, and the ammoniacal and 
putrid odors heretofore mentioned, if detected in freshly 
voided urine, suggests in the case of the former decomposi- 
tion in the bladder and is frequently associated with 
cystitis ; a putrid odor is usually associated with pus. 

The Amount voided in health may vary greatly 
from many causes, such as quantity of fluids or varieties 
of food ingested, and the greater or less elimination of 
water through the skin, bowels, and lungs. The limit is 
usually placed at from 600 C. C. to 1800 C. C. 

Pathologically the amount may vary from none at 
all, complete suppression, or just a few ounces as in acute 
Bright' s disease, to several quarts as in diabetes and 
chronic interstitial nephritis. 

The Amount of Solids normally excreted in the urine 
in twenty-four hours is sixty to sixty-five grams, and is 
quite constant. This determination may be made as 
follows: The total twenty-four hours' urine should be 
collected, measured, and the specific gravity carefully 



706 Examination of Urine. 

taken from the mixed specimen. Multiply the last two 
figures of the specific gravity (carried out to four figures) 
by 2.33 (Trapp's Coefficient) which will give, with 
approximate accuracy, the number of grams of solid 
matter contained in 1000 C. C. The total amount of 
urine voided in the twenty-four hour period having been 
ascertained, the total solids in this quantity may be 
readily calculated. 

If this estimate is made several succeeding days, and 
it is observed that the patient is eliminating much less 
solids than normal, venal inactivity would be indicated; 
especially would this be true in fevers when we have 
great tissue waste, and proportion of solids should be 
largely above normal and if not eliminated danger is 
present. 

Albumin. — Serum-albumin is the albumin usually 
found in the urine and this variety is always indicated 
when speaking of urinary albumin. 

The presence of albumin in the urine can hardly under 
any circumstances be considered as a normal constituent, 
although the existence of a "physiological" albuminuria is 
claimed by some authorities; this, however, is transient 
in character and unimportant. 

Albumin may vary in the urine from a mere trace to 
an amount which causes the specimen to become almost 
solid on boiling. 

The principal conditions in which albumin is present 
in the urine, are: febrile albuminuria; functional 
albuminuria; albuminuria due to blood changes, as 
scurvy, purpura, severe ansemia, lead or mercury poison- 
ing, etc.; neurotic albuminuria, after epileptic attacks, 
apoplexy, tetanus, etc.; congestion of the kidney; 
organic diseases of the kidney — acute and chronic, 
Bright's disease, amyloid and fatty degeneration, pyelitis, 
etc.; extra-venal albuminuria, when the urine may be 
free from albumin when secreted, but become mixed 



Examination of Urine. 707 

with some albuminous material, such as pus, blood or 
lymph, from the time it issues from the venal tubules 
and the time it is voided from the bladder. 

Tests for Albumin. — The urine should be perfectly 
clear, and if filter paper fails to overcome any turbidity, 
a small quantity of talcum added to the specimen and 
thoroughly agitated before filtration is attempted will 
usually overcome this difficulty. 

Tests for albumin are numerous and all have more or 
less to recommend them; we have here selected two that 
have proven entirely dependable and are of the opinion 
that one or two tests, with which one has become thor- 
oughly familiar, are more satisfactory than many. 

HEAT AND NITRIC ACID. 

A TEST tube partially filled with perfectly clear urine 
^ ^ is heated to boiling over a flame; if a cloudiness 
becomes visible it is due either to albumin or earthy 
phosphates. If earthy phosphates, the cloudiness promptly 
disappears on the addition of a few drops of nitric acid; 
if albumin, it is permanent and may be increased. 

It should be borne in mind that a very small amount 
of albumin may not be precipitated by heat alone, 
without the addition of nitric acid, and that earthy 
phosphates are precipitated by heat and redissolved on 
addition of nitric acid. If care is not exercised, a faint 
cloudiness, indicating a trace of albumin, may not be 
readily observed, and the tested portion should be com- 
pared with the original specimen against a dark back- 
ground, when an extremely slight turbidity, if present, 
may be readily seen, which will settle after a short time. 
In the application of this test the addition of too little 
acid may fail to cause precipitation, and too much may 
redissolve the precipitate. It is quite essential that the 
amount of acid and urine be in proper proportion; the 



708 Examination of Urine. 

use of about one-twentieth as much acid as urine will 
usually result most satisfactorily. 

By always using the same amount of acid and urine 
we may form some idea as to quantity of albumin by the 
bulk of the precipitate and is especially useful for com- 
parison. 

Heller's Ring Test will usually indicate traces of 
albumin, and if properly applied is a very satisfactory 
one, but it is not as delicate a test as some we have 
mentioned. 

Upon a convenient quantity of pure nitric acid, in 
a small test tube, an equal quantity of clear urine is 
carefully added, by allowing same to flow very slowly 
and gently down the side of the tube and overlie the acid. 

If albumin is present a sharp white ring or zone will 
appear at the point of contact between the urine and 
acid, varying in thickness with the amount of albumin 
present. 

This method is not entirely satisfactory from the 
fact that it is extremely difficult to avoid an admixture 
of the fluids, in which case the test is a failure. 

However, there is a modification of this that has 
proven most satisfactory and is' known as Boston's 
Pipette Method. 

A piece of glass tubing about one-fourth inch in 
diameter and eight or ten inches long is used. With 
the finger pressed firmly over the upper end of the tube 
it is introduced into the specimen; by relaxing the pres- 
sure of the finger, urine is allowed to flow up in the tube 
to the distance of about one inch. Firm pressure being 
resumed the tube is removed from the vessel containing 
the urine, rinsed off carefully on the outside and wiped 
dry, then introduced into a test tube containing pure 
nitric acid to the depth of about two inches; the pressure 
of the finger is again relaxed, allowing the acid to run in. 



Examination of Urine. 709 

Pressure is again applied and the tube carefully removed 
for inspection. 

If properly applied, there should be a sharp line of 
demarcation between the two liquids, and if albumin is 
present, a distinct white ring will form at this point, 
varying in depth with the percentage of albumin. It 
should be borne in mind that a brown ring forms at this 
point in normal urine, and grows in intensity on standing, 
due to the action of the acid on the coloring matter of 
the urine, and should in nowise be confused with the 
white ring of albumin. 

Sugar. — The sugars of clinical importance found in 
the urine are principally glucose, in a few cases lactose. 
Maltose, levulose, inosite, and the pentoses may be 
rarely found, but their presence has little significance. 
Normal urine contains a trace of glucose, but so small 
that it does not interfere with any clinical tests. 

The presence of sugar in minute quantities may be 
detected occasionally with those who are unable to 
digest large quantities of carbonaceous foods and have 
indulged to excess, but if persistent it is a most depend- 
able symptom of diabetes mellitus. 

TESTS FOR SUGAR. 

/^\F the large number of tests for sugar, two have been 
^S selected, which for practical purposes will be con- 
clusive of more satisfaction than less familiarity with 
many. 

Albumin if present in specimen should be removed by 
boiling and filtration. 

HAINE'S TEST. 

/ HPHIS is a modification of Fehling's test, the solution 
A is quite stable, can ordinarily be kept almost indef- 
initely, obviates the necessity of using two solutions, and 
is the best of the copper tests. 



710 Examination of Urine. 

Formula. — Take copper sulphate pure thirty grains, 
distilled water one-half ounce; dissolve; add glycerine 
pure one-half ounce, liquor potassse, five ounces. 

Test. — Take about one dram of the solution in a test 
tube and boil over a name; add two or three drops at a 
time, and not more than eight drops in all, of the urine 
to be tested, boiling after each addition. 

If sugar is present a yellow, or yellowish-red, pre- 
cipitate is thrown down. It is a wise precaution to always 
carefully observe that the test solution remains unaffected 
by boiling, before any urine is added, thus being assured 
that it is in perfect condition, and to not add more than 
eight drops of the suspected urine, otherwise pseudo- 
reactions sometimes occur which are confusing and 
misleading. 

FERMENTATION TEST. 

'"T^HIS consists in determining the specific gravity of 
■*■ the urine before and after fermentation and proves 
quite satisfactory as a quantitative test. Carbon dioxide 
and alcohol are formed as a result of the fermentation of 
sugar and the specific gravity is lowered thereby, both on 
account of the decomposition of the sugar and the 
production of alcohol. 

It was established by Roberts that a decrease of 
0.001 in the specific gravity, after fermentation, corre- 
sponded to 0.23 per cent of sugar. In performing this 
test, two six-ounce wide-mouth bottles may be used, 
filling each about three-fourths with the urine to be 
tested, which should be faintly acid and if necessary 
acidulated with tartaric acid; cork one bottle up care- 
fully and see that it is kept free from contamination. 

To the other add a piece of compressed yeast about 
the size of a pea and see that same is thoroughly sub- 
divided by agitation; close this bottle with a cork in which 



Examination of Urine. 711 

a small notch has been cut to permit the escape of carbon 
dioxide. Allow both bottles to stand at temperature of 
room, or preferably 70 to 75 degrees F., for twenty-four 
hours or longer, until fermentation is complete, which 
should be verified by a negative reaction with Haine's 
test. After fermentation is complete, filter and deter- 
mine specific gravity carefully, also specific gravity of 
control test which was not subjected to fermentation. 

The difference in specific gravity between the fer- 
mented and unfermented urine multiplied by .23 will 
give approximately the percentage of sugar. 

In our brief treatment of this subject it will be observed 
that tests for normal constituents have not been con- 
sidered. While they are occasionally of value, it is only 
when quantitative estimations are made, and such 
estimation made from a separate portion of urine, or 
that from a single day, disregarding many conditions 
that must be given consideration, can lead to no deduc- 
tions of real diagnostic or prognostic value, and should 
as a rule be left to an expert or until one has mastered 
the subject quite thoroughly, or much time may be 
wasted and results attained that are unsatisfactory and 
misleading. Whereas information of much greater value 
may be gained by the more readily acquired and simply 
applied qualitative tests for the more important abnormal 
constituents. 

The microscopic examination of urinary sediments, 
a most valuable and interesting branch of this work, has 
not here been considered from the fact that plates show- 
ing the character and appearance of sediments under 
the microscope are very essential for its study in a 
satisfactory manner; and for this class of work, as well 
as a more extended treatise on qualitative tests, together 
with quantitative estimations, the reader is referred to 
the many well-written works devoted exclusively to the 
subject of the examination of urine, in all its phases. 



712 Examination of Urine. 

Enumerated below, are the apparatus and reagents 
required for the tests herein outlined: 

Urinometer. 

Test tubes, four and six inches. 

Test tubes, rack and brush. 

Glass funnels, two to three inch. 

Spirit lamp or bunsen burner. 

Glass tubing for pipette. 

Wide mouth bottles, six ounces. 

Small graduate or graduated cylinder. 

Filter paper to fit funnels. 

Litmus paper, red and blue. 

Nitric acid, pure. 

Haine's test solution. 



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